VALIDATION OF SIMPLIFIED GERIATRIC ASSESSMENT AND ELDERLY PROGNOSTIC INDEX IN OLDER PATIENTS WITH DIFFUSE LARGE B‐CELL LYMPHOMA IN CHINA

Introduction: Diffuse large B-cell lymphoma (DLBCL), with a median age of 66 years at diagnosis, is the most common malignant lymphocytic tumor and predominantly affects elderly individuals. To predict the prognosis of elderly DLBCL patients, the Fondazione Italiana Linforni (FIL) developed the simplified geriatric assessment (sGA; shown in Figure 1A) and Elderly Prognostic Index (EPI; shown in Figure 1B). Both sGA and EPI are associated with overall survival (OS) and progression-free survival (PFS) of older patients with DLBCL, while EPI could predict early mortality in these cohorts. However, whether sGA and EPI are suitable for elderly patients with DLBCL in China has not been further explored. Methods: The study included 257 patients with DLBCL aged ≥65 years who were newly diagnosed in Beijing Hospital and Peking University Third Hospital from December 2007 to December 2020. Kaplan-Meier curves were performed to evaluate the prognostic value of sGA and EPI. The receiver operating characteristics curve (ROC) was used to assess the sensitivity and specificity. Results: According to the criteria of sGA, 257 patients were stratified into fit (45.1%), unfit (35.4%) and frail (19.5%) groups. Due to insufficient information in the medical records, the 247 patients were identified as low-risk group (15.0%), intermediate-risk group (40.1%) and high-risk group (44.9%). The median follow-up was 23 months (range 1–127 months). As shown in Figure 1C and Figure 1D, both sGA (p < 0.001) and EPI (p = 0.008) were related to OS of elderly patients with DLBCL. ROC curves showed that both sGA (AUC: 0.602; 95% CI: 0.530–0.674; p = 0.006) and EPI (AUC: 0.584; 95% CI: 0.512–0.656; p = 0.027) could predict the OS of elderly patients with DLBCL (shown in Figure 1E). Similarly, both sGA (p = 0.015; shown in Figure 1F) and EPI (p = 0.023; shown in Figure 1G) were related to the PFS of elderly patients with DLBCL. Regrettably, ROC curves showed that neither sGA (AUC: 0.555; 95% CI: 0.479–0.630; p = 0.158) nor EPI (AUC: 0.544; 95% CI: 0.468–0.619; p = 0.268) could predict the PFS (shown in Figure 1H). The next section of the study was concerned with the predictive value of sGA and EPI in early mortality of elderly patients with DLBCL. Figure 1I and Figure 1J indicated that sGA (p = 0.002) and EPI (p = 0.015) were associated with the early mortality of elderly patients with DLBCL, separately. ROC curves explicated that both sGA (p = 0.002; AUC: 0.744; 95% CI: 0.634-0.853) and EPI (p = 0.009; AUC:0.703; 95% CI: 0.590-0.815) could predict the early mortality of elderly patients with DLBCL (shown in Figure 1K). The research was funded by: grants from the National High Level Hospital Clinical Research Funding (No. BJ-2022-127), CAMS Innovation Fund for Medical Sciences (CIFMS, No. 2021-I2M-C&T-A-020), the Beijing Natural Science Foundation (No. 7232137), and Beijing Health Technologies Promotion Program (No. BHTPP2022094). Keywords: non-Hodgkin (pediatric, adolescent, and young adult), other No conflicts of interests pertinent to the abstract.