Functional status and therapy for older adults with diffuse large B-cell lymphoma in nursing homes: A population-based study

Details

• Alternative Title:
  J Am Geriatr Soc
• Personal Author:
  Di, Mengyang ; Keeney, Tamra ; Belanger, Emmanuelle ; Huntington, Scott F. ; Olszewski, Adam J. ; Panagiotou, Orestis A.
• Description:
  Objectives:
  
  To characterize the prevalence of functional and cognitive impairments, and associations between impairments and treatment among older patients with diffuse large B cell lymphoma (DLBCL) receiving nursing home (NH) care.
  
  Methods:
  
  We used the Surveillance, Epidemiology, and End Results-Medicare database to identify beneficiaries diagnosed with DLBCL 2011–2015 who received care in a NH within − 120 ~ + 30 days of diagnosis. Multivariable logistic regression was used to compare receipt of chemoimmunotherapy (including multi-agent, anthracycline-containing regimens), 30-day mortality, and hospitalization between NH and community-dwelling patients, estimating odds ratios (OR) and 95% confidence interval (CI). We also examined overall survival (OS). Among NH patients, we examined receipt of chemoimmunotherapy based on functional and cognitive impairment.
  
  Results:
  
  Of the eligible 649 NH patients (median age: 82 years), 45% received chemoimmunotherapy; among the recipients, 47% received multi-agent, anthracycline-containing regimens. Compared with community-dwelling patients, those in a NH were less likely to receive chemoimmunotherapy (OR: 0.34, 95%CI: 0.29–0.41), had higher 30-day mortality (OR: 2.00, 95%CI: 1.43–2.78) and hospitalization (OR: 1.51, 95%CI: 1.18–1.93), and poorer OS (hazard ratio: 1.36, 95%CI: 1.11–1.65). NH patients with severe functional (61%) or any cognitive impairment (48%) were less likely to receive chemoimmunotherapy.
  
  Conclusions:
  
  High rates of functional and cognitive impairment and low rates of chemoimmunotherapy were observed among NH residents diagnosed with DLBCL. Further research is needed to better understand the potential role of novel and alternative treatment strategies and patient preferences for treatment to optimize clinical care and outcomes in this high-risk population.
  
  
• Subjects:
  Aged Aged, 80 And Over Anthracyclines Functional Status Humans Lymphoma, Large B-Cell, Diffuse Medicare Nursing Homes Retrospective Studies United States
• Keywords:
  Chemoimmunotherapy Diffuse Large B Cell Lymphoma Functional And Cognitive Impairment Geriatric Oncology Nursing Home
• Source:
  J Am Geriatr Soc. 71(7):2239-2249
• Pubmed ID:
  36882865
• Pubmed Central ID:
  PMC10483014
• Document Type:
  Journal Article
• Funding:
  HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; UL1 TR001863/TR/NCATS NIH HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; T32 HS000011/HS/AHRQ HHSUnited States/
• Volume:
  71
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:511e4306ec743589e011b0a03f781f95d489d23e133a4ae4ed1bac68ccb26c67d3cac5d0253a8ca36771b4c1ef8fd33eff3f2cd1984166d52a81e96f39341d9b
• Download URL:
  https://stacks.cdc.gov/view/cdc/132834/cdc_132834_DS1.pdf
• File Type:
  [PDF - 682.44 KB ]