Determination and Management of Risks for Practices and Procedures in the Elderly (DRIPP): the impact of a comprehensive geriatric evaluation in elderly with diffuse large B-cell lymphoma

Fernando Warley; Mariana Kalmus; Nancy Cristaldo; Victoria Otero; Ileana L Ismael; Bruno Boietti; Maximiliano Smietniansky

doi:10.1016/j.htct.2023.09.2367

Determination and Management of Risks for Practices and Procedures in the Elderly (DRIPP): the impact of a comprehensive geriatric evaluation in elderly with diffuse large B-cell lymphoma

Hematol Transfus Cell Ther. 2023 Nov 29:S2531-1379(23)02587-7. doi: 10.1016/j.htct.2023.09.2367. Online ahead of print.

Authors

Fernando Warley¹, Mariana Kalmus², Nancy Cristaldo², Victoria Otero², Ileana L Ismael³, Bruno Boietti³, Maximiliano Smietniansky⁴

Affiliations

¹ Hematology Section, Internal Medicine Department, Hospital Italiano de Bueno Aires, Argentina. Electronic address: ferwarley@gmail.com.
² Hematology Section, Internal Medicine Department, Hospital Italiano de Bueno Aires, Argentina.
³ University Institute Hospital Italiano de Buenos Aires, Argentina.
⁴ Geriatric section, Internal Medicine Department, Hospital Italiano de Buenos Aires, Argentina; DRIPP program coordinator, Buenos Aires, Argentina.

PMID: 38307825
DOI: 10.1016/j.htct.2023.09.2367

Abstract

Introduction: Diffuse large B-cell lymphoma (DLBCL) treatment in older patients is challenging. The Determination and Management of Risks for Practices and Procedures in the Elderly (DRIPP) is a multidimensional evaluation program that involves patients undergoing oncological treatments.

Objective: We aimed to evaluate the overall survival and progression-free survival (PFS) of patients evaluated and those not evaluated by the DRIPP.

Materials and methods: Retrospective cohort study, patients > 65 years with DLBCL were included. They were divided into 3 groups: patients with a diagnosis prior to the DRIPP implementation (pre-DRIPP), patients with the DRIPP (DRIPP) and patients with a diagnosis after the DRIPP implementation, but who did not undergo the evaluation (non-DRIPP).

Results: A total of 125 patients were analyzed. Fourteen (11%) patients in the pre-DRIPP group, 74 (59%) in the DRIPP group, and 37 (30%) in the non-DRIPP group. In 43 (58%) patients of the DRIPP group, some drug dose adjustments were made vs. 19 (15%) in the non-DRIPP (p = 0.03). There were no significant differences in terms of discontinuation of treatment or hematological toxicity between groups. The OS and PFS in one year was 64% (95%CI 34-83) and 50% (95%CI 23-72) for the pre-DRIPP group, 82% (95%CI 71-89) and 72% (95%CI 60-81) for the DRIPP group, 58% (95% CI 41-72) and 56% (95% CI 38-70) for the non-DRIPP group, (p = 0.08). The analysis was adjusted for probable confounders and no differences were found.

Conclusions: This is the first study to evaluate the DRIPP as a decision-making tool in patients with lymphoma and showed a trend towards improvement in the OS in evaluated patients.

Keywords: DRIPP; Elderly; Lymphoma.