Objective To discuss the prognosis-related factors for elderly patients with diffuse large B-cell lymphoma and survival analysis of different therapy. Methods We retrospectively analyzed the clinical data from 72 elderly patients with initial diffuse large B-cell lymphoma. The evaluable 64 cases were eligible. The parameters included gender, age, clinical stage, B symptom, ECOG performance status (ECOG-PS), extra lymphnodes invasion, serum level of lactate dehydrogenase (LDH), hemoglobin level, international prognostic index (IPI). The survival analysis and Cox proportional hazards regression model were conducted. To We also compared the survival of 34 patients who received 3-week CHOP chemotherapy and 30 patients 3-week R-CHOP chemotherapy. Results The median follow-up of the total study population was 40.3 months. The estimated 2-year overall survival (OS) of all patients was 67.43%, the estimated 3-year OS was 49.89%. In the multivariate analysis that include age, clinical stage, ECOG-PS, IPI were the independent factor predicting overall survival (P< 0.05). The estimated 2-year OS (53.3% vs 72.1%, P< 0.05) and 3-year OS (39.2%vs60.8%, P< 0.05) had significant difference between CHOP and R-CHOP group. Conclusion Age, clinical stage, ECOG-PS, IPI were independent predictive and prognostic factor in elderly patients with DLBCL. R-CHOP chemotherapy has more advantages than CHOP chemotherapy in survival.%目的 探讨老年弥漫性大B细胞淋巴瘤(DLBCL)预后因素,不同治疗方案对其生存的影响.方法 回顾性分析72例初发老年DLBCL的性别、年龄、临床分期、B症状、ECOG-PS评分、结外病灶、血清LDH水平、血红蛋白水平、IPI评分与预后的相关性,其中可评价的为64例.比较接受3周CHOP方案34例和接受3周R-CHOP方案30例的生存情况.结果 老年DLBCL患者中位生存期40.3个月,2年OS率67.43％,3年OS率49.89％.多因素分析显示年龄、ECOG-PS、临床分期、IPI评分是影响老年DLBCL患者预后的独立危险因素(P＜0.05).CHOP组和R-CHOP组2年及3年OS率差异均有统计学意义,2年OS率(53.3％ VS 72.1％,P＜ 0.05),3年OS率(39.2％vs60.8％,P＜ 0.05).结论 年龄、ECOG-PS、临床分期、IPI评分是老年DLBCL患者的预后相关因素,R-CHOP方案疗效优于CHOP方案.
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