An evaluation based on relative treatment intensity in older patients treated with reduced-dose R-THP-COP therapy for diffuse large B-cell lymphoma: A multicenter retrospective cohort study

Comparison of the outcomes of patients with primary central nervous system lymphoma between the neurosurgery and hematology/oncology departments based on the relative dose intensity of methotrexate

“…In addition to the differences in RDI, the number of courses administered also differed between the two departments. A previous study of DLBCL suggested that relative treatment intensity may be valuable for assessing treatment intensity in retrospective studies in which different numbers of chemotherapy courses were administered (10). In this study, the PCNSL patients treated at the hematology/oncology department received high-dose MTX therapies at significantly higher treatment intensities than those treated at the neurosurgery department.…”

“…For patients in whom the high-dose MTX regimen was discontinued, the RDI was calculated based on the number of courses administered. The relative treatment intensity of MTX was calculated by multiplying the RDI of MTX by the number of MTX-based chemotherapy courses, as previously reported in a study of older DLBCL patients based on relative treatment intensity (10). For example, if three courses of MTX involving a dose of 3.5 g/m 2 were administered every two weeks without postponement, the relative treatment intensity for MTX would be three.…”

Use of R-mini-CHP in combination with polatuzumab vedotin (pola-R-mini-CHP) as the primary treatment in ≥80-year-old cases with diffuse large B-cell lymphoma

“…In Japan, non-Hodgkin’s lymphoma (NHL) accounts for about 40% of all hematologic malignancies 1 diffuse large B-cell lymphoma (DLBCL) accounts for about 45% of all NHLs, 1 and is the most common hematologic malignancy encountered in clinical practice. 1 Furthermore, the incidence of DLBCL is on the rise among the elderly, 2 and cases aged ≥80 years account for approximately 23%. 1 The incidence of DLBCL in this age group is likely to increase further in the future, with the aging of the population.…”

“… 1 This is considered to be due to a higher frequency of comorbidities and reduced organ function reserve than in younger cases, resulting in a higher incidence of adverse events (AEs) and earlier mortality. 2 In addition, in the elderly aged ≥80 years, it is known that the frequency of the activated B-cell (ABC) type is higher, accounting for about 60% to 70%, 3 and also that the BCL2 and MYC gene expressions and cytogenetic complexity increase. 4 These factors are considered to be associated with a poor prognosis.…”

“… 4 Notwithstanding, there is no established treatment for DLBCL in this age group. 2 , 5 The number of clinical studies conducted in this age group is limited: although one phase III study 6 and two phase II studies have been reported, 7 , 8 most of these were retrospective analyses, 9 , 10 and there are few reports of studies providing high-quality evidence.…”