老年套细胞淋巴瘤的临床特征和预后影响因素

OBJECTIVE: To examine the clinical characteristics and prognostic factors of elderly patients with mantle cell lymphoma（MCL）and the impact of nutrition and underlying diseases on the prognosis of elderly patients with MCL. METHODS: retrospectively analyzed 255 elderly patients with MCL from 11 medical centers, including Peking University Third Hospital between January 2000 and February 2021. We analyzed clinical data, such as age, gender, Mantle Cell Lymphoma International Prognostic Index score, and treatment options, and performed univariate and multivariate prognostic analysis. We performed a comprehensive geriatric assessment on elderly MCL patients with medical records that included retraceable underlying disease and albumin levels, and we investigated the impact of basic nutrition and underlying disorders on MCL prognosis in the elderly. RESULTS: There were 255 senior individuals among the 795 MCL patients. Elderly MCL was more common in males (78.4％), with a median age of 69 yr (ages 65–88), and the majority (88.6％) were identified at a late stage. The 3-yr overall survival (OS) rate was 42.0％, with a 21.2％ progression-free survival (PFS) rate. The overall response rate (ORR) was 77.3％, with a 33.3％ total remission rate. Elderly patients were more likely than younger patients to have persistent underlying illnesses, such as hypertension. Multivariate analysis revealed that variables related with poor PFS included age of ≥80 (P＝0.021), Ann Arbor stage Ⅲ–Ⅳ (P＝0.003), high LDH level (P＝0.003), involvement of bone marrow (P＝0.014). Age of ≥80 (P＝0.001) and a high LDH level (P＝0.003) were risk factors for OS. The complete geriatric assessment revealed that renal deficiency was associated with poorer OS (P＝0.047). CONCLUSION: Elderly MCL patients had greater comorbidities. Age, LDH, renal function, bone marrow involvement, and Ann Arbor stage are all independent risk factors for MCL in the elderly.