Age, Comorbidity Burden and Treatment Outcomes in Mature B‐Cell Lymphoproliferative Disorders: A Real‐World Study

INTRODUCTION: Treatment decisions in older patients with mature B-cell lymphoproliferative disorders (MBLD) are frequently guided by chronological age and comorbidity burden, although their ability to predict clinically relevant outcomes remains uncertain. METHODS: We conducted a retrospective real-world study including 172 patients with MBLD between 2016 and 2021, assessing the association of age and comorbidity burden (standardised using the Cumulative Illness Rating Scale for Geriatrics, CIRS-G score) with treatment intensity, toxicity, and clinical outcomes. RESULTS: Treatment intensity decreased significantly with both age (p = 0.003) and CIRS-G score (p < 0.001). However, neither age nor CIRS-G score was associated with an increased rate of treatment-related toxic events. In contrast, older age was associated with worse overall survival and lower response rates (all p < 0.05), whereas CIRS-G score was not significantly associated with these outcomes. Similar associations between age and outcomes were observed in the DLBCL subgroup. CONCLUSION: In this real-world cohort of patients with MBLD, chronological age was more consistently associated with treatment patterns and clinical outcomes than comorbidity burden as measured by the CIRS-G score. These findings suggest that chronological age alone may not adequately capture the heterogeneity of older patients and support the use of more comprehensive assessments of frailty and functional status to inform treatment decisions.