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Is Frailty a Predictor of Survival in Patients With Newly Diagnosed DLBCL?

By: Jenna Carter, PhD
Posted: Wednesday, July 27, 2022

An article published in JNCCN–Journal of the National Comprehensive Cancer Network reported findings on the association between frailty and 1-year mortality in patients newly diagnosed with diffuse large B-cell lymphoma (DLBCL). Matthew C. Cheung MD, SM, of the Sunnybrook Odette Cancer Center, Toronto, and colleagues conducted a retrospective cohort study in patients receiving curative-intent therapy. They found that frail patients were significantly more likely to present to the emergency department, be admitted to the hospital, and/or be admitted to the intensive care unit during treatment.

“Recent work has shown the importance of frailty as a predictor of survival in patients with DLBCL…. [However], the mechanism by which frailty impacts survival remains unclear…,” stated Dr. Cheung and colleagues. Future work should investigate the impact of frailty on treatment outcomes and whether frailty should be used to inform treatment decisions, they noted.

A total of 5,527 patients with DLBCL were included in this study. To assess frailty, a modified version of the generalizable frailty index was used. The primary study outcome was 1-year mortality from the index date, identified using vital status records from the Ontario Registered Persons Database. Secondary outcomes included overall survival, cancer-related death, death during active cancer treatment, chemoimmunotherapy cycles received, and health-care use during treatment.

Findings revealed that 2,699 (49%) patients were classified as frail. Additionally, frail patients tended to be older than nonfrail patients (median age = 76 years, interquartile range [IQR] = 71–81 years vs. 74 years, IQR = 70–79 years). The median duration of follow-up was 324 days, during which 2,964 (54%) patients died (1,626 [60%] frail and 1,338 [47%] nonfrail). They also found that within 90 days of initiation of first-line treatment, the survival probability ± standard error among frail patients was 86% ± 0.67% versus 93% ± 0.47% for nonfrail patients (P < .0001). Within 1 year of first-line treatment, it was 68% ± 0.90% versus 81% ± 0.75%, respectively.

Disclosure: The study authors reported no conflicts of interest.


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