Impact of Age on Biology, Presentation and Outcomes in Marginal Zone Lymphoma: Results From a Multicenter Cohort Study

Given the paucity of age-specific data about biology, presentation, and treatment outcomes in adults with MZL, we sought to evaluate differences between younger (≤ 70 years) and older (> 70 years) patients with MZL in a large retrospective cohort treated in the contemporary era (2010 onwards). The primary objective was progression-free survival (PFS), while secondary objectives included the evaluation of overall survival (OS) and the cumulative incidence of transformation between the 2 groups. A total of 598 patients were included in the analysis and among these 32% were > 70 years of age. There were no age-based differences in the prevalence of NMZL, SMZL, and EMZL. Older patients had a higher incidence of adverse prognostic features at diagnosis such as worse performance status, advanced stage disease, and bone marrow involvement, yet were more likely to be treated with single-agent rituximab than chemoimmunotherapy. Age > 70 years was associated with inferior PFS and OS after controlling for clinically relevant risk factors and accounting for differences in first-line treatment. Receipt of rituximab monotherapy was associated with significantly inferior PFS overall, however, the type of first-line therapy did not impact OS in any group. Our data suggests that despite the development of new drugs for MZL, age remains an independent predictor of inferior outcomes. Investigation of targeted therapy combinations in the first-line setting may yield the required balance of efficacy and toxicity in older adults with MZL.

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Publication Details

Journal
Hematological Oncology
Published
2025-04-22
DOI
https://doi.org/10.1002/hon.70087
Citations
2
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
2.94
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article

Impact of Age on Biology, Presentation and Outcomes in Marginal Zone Lymphoma: Results From a Multicenter Cohort Study

Reem Karmali, Marcus P. Watkins, Geoffrey Shouse, Praveen Ramakrishnan Geethakumari et al.
2 citations
Hematological Oncology
Lymphoma Diagnosis and Treatment
2.94
article

Impact of Age on Biology, Presentation and Outcomes in Marginal Zone Lymphoma: Results From a Multicenter Cohort Study

Reem Karmali, Marcus P. Watkins, Geoffrey Shouse, Praveen Ramakrishnan Geethakumari, Stefan Klaus Barta, Kaitlin Annunzio, Montreh Tavakkoli, Pallawi Torka, Adam J. Olszewski, Andrea Anampa‐Guzmán, Heather Reves, Natalie Sophia Grover, Nancy L. Bartlett, Narendranath Epperla, Timothy J. Voorhees, Colin Thomas, Beth Christian
article en
2 citations

Abstract

Given the paucity of age-specific data about biology, presentation, and treatment outcomes in adults with MZL, we sought to evaluate differences between younger (≤ 70 years) and older (> 70 years) patients with MZL in a large retrospective cohort treated in the contemporary era (2010 onwards). The primary objective was progression-free survival (PFS), while secondary objectives included the evaluation of overall survival (OS) and the cumulative incidence of transformation between the 2 groups. A total of 598 patients were included in the analysis and among these 32% were > 70 years of age. There were no age-based differences in the prevalence of NMZL, SMZL, and EMZL. Older patients had a higher incidence of adverse prognostic features at diagnosis such as worse performance status, advanced stage disease, and bone marrow involvement, yet were more likely to be treated with single-agent rituximab than chemoimmunotherapy. Age > 70 years was associated with inferior PFS and OS after controlling for clinically relevant risk factors and accounting for differences in first-line treatment. Receipt of rituximab monotherapy was associated with significantly inferior PFS overall, however, the type of first-line therapy did not impact OS in any group. Our data suggests that despite the development of new drugs for MZL, age remains an independent predictor of inferior outcomes. Investigation of targeted therapy combinations in the first-line setting may yield the required balance of efficacy and toxicity in older adults with MZL.

Hematological OncologyVol. 43(3)
Northwestern University (US), University of North Carolina at Chapel Hill (US), Roswell Park Comprehensive Cancer Center (US), City Of Hope National Medical Center (US), Memorial Sloan Kettering Cancer Center (US), Thomas Jefferson University (US), Washington University in St. Louis (US), University of Utah (US), Brown University (US), Huntsman Cancer Institute (US), Southwestern Medical Center (US), UNC Lineberger Comprehensive Cancer Center, The Ohio State University (US), University of Pennsylvania (US), The University of Texas Southwestern Medical Center (US)
Good health and well-being
Openalex Percentile: Top 11%
Lymphoma Diagnosis and Treatment
2.94
DOIOpen Access PDFOpenAlex
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