Molecular phenotype of diffuse large B-cell lymphoma as a basis for a personalized treatment approach of elderly patients

Background. The use of molecular genetic profiling in clinical practice and the registration of immunotargeted agents have undoubtedly led to the development of a personalized approach in oncohematology, with diffuse large B-cell lymphoma (DLBCL) being no exception. Elderly patients represent a complex group of patients with DLBCL, which leads to difficulties in treatment due to their comorbidity.
Aim. To evaluate the efficacy, tolerability and safety of an individualized approach based on the mutational landscape in elderly patients with newly diagnosed DLBCL.
Materials and methods. The clinical study included 10 elderly patients with newly diagnosed DLBCL. The median age was 68 (65–78) years. Eight patients were classified as being at high risk of early progression according to the international prognostic index. The frequency of genotypes in the considered cohort of elderly patients: MCD – 1 (10 %), N1 – 3 (30 %), BN2 – 1 (10 %), EZB – 2 (20 %), NOS – 3 (30 %).
Results. Overall and complete metabolic response rates were 100 %. Clinically significant hematological toxicity depending on the number of cycles (n = 60): grade III–IV neutropenia in 5 cycles, grade III–IV thrombocytopenia in 2, grade III–IV anemia in 3. Non-hematological toxicity did not exceed grades I–II.
Conclusion. High efficacy and low toxicity profile of a personalized approach in elderly patients with newly diagnosed DLBCL were demonstrated. The obtained preliminary results indicate the possibility of continuing the developed clinical study of elderly patients with DLBCL.

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