Original Articles
Vol. 17 No. 1 (2025): Review Articles, Original Article, Scientific Letter, Case Reports Letter to the Editor
The MINI-POLATUZUMAB VEDOTINE PLUS CHP (POLA-R-CHP) VS. MINI-R-CHOP IN PATIENTS OVER 80 YEARS OF AGE WITH DIFFUSE LARGE B-CELL LYMPHOMA: A RETROSPECTIVE, PROPENSITY SCORE-MATCHED ANALYSIS STRATIFIED BY SIMPLIFIED FRAILTY SCORE
PolaRCHP vs. RCHOP for older patients
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: July 4, 2025
Accepted: September 27, 2025
Accepted: September 27, 2025
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Background: Polatuzumab vedotin (Pola) combined with rituximab, cyclophosphamide, doxorubicin, and prednisolone (PRCHP) is a new standard first-line therapy; however, patients aged >80 years were excluded from the POLARIX trial. This retrospective study evaluated the efficacy and safety of mini-PRCHP and mini-rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) in older patients.
Methods: Sixty-three participants aged >80 years were treated with PRCHP, and 76 were treated with RCHOP between January 2018 and December 2024 at our hospital. Propensity score matching (PSM) was performed for Ann Arbor stage, international prognosis index, and frailty score to adjust for baseline differences.
Results: After a 1:1 PSM matching, 59 patient pairs were selected (median age: 84 years; p=0.88). Patients were classified as fit (n=9, 15%), unfit (n=21, 36%), or frail (n=29, 49%) according to their frailty scores (p=1.00). The overall response rate (ORR), complete response rate (CRR), overall survival (OS), and progression-free survival (PFS) at 12 months were not significantly different between the mini-PRCHP and mini-RCHOP groups. In patients with frailty, the 12-month PFS was not significantly different (50.9% vs. 53.7%, p=0.87); however, in non-frail patients, the PFS was significantly higher in the mini-PRCHP group than that in the mini-RCHOP group (80.8% vs. 60.1%, p=0.04). Safety profile of grade 3/4 adverse events was similar for both groups; however, peripheral neuropathy was prominent in the mini-RCHOP group (p=0.06).
Conclusion: Mini-PRCHP demonstrated efficacy and safety comparable to mini-RCHOP in older patients. Mini-PRCHP may prolong PFS in non-frail patients and reduce the risk of peripheral neuropathy.
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“The MINI-POLATUZUMAB VEDOTINE PLUS CHP (POLA-R-CHP) VS. MINI-R-CHOP IN PATIENTS OVER 80 YEARS OF AGE WITH DIFFUSE LARGE B-CELL LYMPHOMA: A RETROSPECTIVE, PROPENSITY SCORE-MATCHED ANALYSIS STRATIFIED BY SIMPLIFIED FRAILTY SCORE: PolaRCHP vs. RCHOP for older patients” (2025) Mediterranean Journal of Hematology and Infectious Diseases, 17(1), p. e2025070. doi:10.4084/MJHID.2025.070.
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