Abstract / Summary
Summary Using LYmphoma Study Association clinical trials combining 438 first‐line large B‐cell lymphomas (LBCL) patients >80 years old, we defined SENIOR‐IPI, an easily applicable prognostic index for this elderly population treated with an anti‐CD20‐miniCHOP (cyclophosphamide, doxorubicin, vincristine and prednisone)‐based regimen. SENIOR‐International Prognostic Index (SENIOR‐IPI) takes into account accessible variables (number of aaIPI predictors, lactate dehydrogenase > 3x Upper Limit of Normal (LDH >3× ULN), albumin <35 g/L and number of years over 80) and segregates patients into four risk categories. In the training cohort, SENIOR‐IPI performed better than IPI, age‐adjusted IPI (aaIPI) and National Comprehensive Cancer Network IPI (NCCN‐IPI) for progression‐free survival (PFS) and overall survival (OS). The validation cohort included 195 patients from the real‐world REal world all dAta in LYmphoma and Survival in Adults (REALYSA) cohort and confirmed better performance of SENIOR‐IPI than IPI, aaIPI and NCCN‐IPI both for PFS ( C ‐index 0.66 vs. 0.61, 0.64 and 0.61 respectively) and OS ( C ‐index 0.67 vs. 0.59, 0.62 and 0.61 respectively). Restricted mean survival times at 2 and 5 years were also evaluated: at 2 years, 10 additional SENIOR‐IPI points led to 3.7 and 3.6 months of survival lost, respectively, in the training and validation cohorts. Overall, SENIOR‐IPI is an easily applicable and reproducible prognostic index, using only readily available clinical and biological data, which better stratifies prognosis of LBCL patients >80 years old fit for age‐adapted immunochemotherapy than IPI, aaIPI and NCCN‐IPI.