The therapeutic strategies for acute myeloid leukemia (AML) patients ineligible for remission induction chemotherapy have been improving in the past decade. Therefore, it is important to define ineligibility for remission induction chemotherapy. We retrospectively assessed 153 consecutive adult de novo AML patients undergoing remission induction chemotherapy and defined early mortality as death within the first 60 days of treatment. The 153 patients were stratified into the early mortality group (n = 29) and the non-early mortality group (n = 124). We identified potential factors to which early mortality could be attributed, investigated the cumulative incidence of early mortality for each aspect, and quantified the elements. The early mortality rate in our study cohort was 19.0%. Age ≥ 65 years (odds ratio (OR): 3.15; 95% confidence interval (CI): 1.05–9.44; p = 0.041), Eastern Cooperative Oncology Group performance status ≥ 2 (OR: 4.87; 95% CI: 1.77–13.41; p = 0.002), and lactate dehydrogenase ≥ 1000 IU/L (OR: 4.20; 95% CI: 1.57–11.23; p = 0.004) were the risk factors that substantially increased early mortality in AML patients. Patients with two risk factors had a significantly higher early mortality rate than those with one risk factor (68.8% vs. 20.0%; p < 0.001) or no risk factors (68.8% vs. 9.2%; p < 0.001). In conclusion, older age, poor clinical performance, and a high tumor burden were risks for early mortality in AML patients receiving remission induction chemotherapy. Patients harboring at least two of these three factors should be more carefully assessed for remission induction chemotherapy.

To investigate the potential treatment evolution and outcome improvement, we retrospectively compared clinical characteristics, therapeutic strategies, treatment responses, and overall survival (OS) in patients diagnosed and treated with lymphoma-associated HLH between 2004–2012 (n = 30) and 2013–2021 (n = 26). Our study showed that the clinical characteristics of lymphoma-associated HLH did not substantially change over the past two decades. However, more patients diagnosed in 2013–2021 were tested for Epstein–Barr virus than those diagnosed in 2004–2012 (69.3% vs. 33.3%; p = 0.021). In addition, Eastern Cooperative Oncology Group performance status 3–4 (hazard ratio (HR): 5.38; 95% confidence intervals (CI): 2.49–11.61; p < 0.001) and jaundice (HR: 2.91; 95% CI: 1.37–6.18; p = 0.006) were poor prognostic factors for lymphoma-associated HLH. With a comparable response rate of lymphoma treatment, patients treated in 2013–2021 had a numerically greater median OS than those treated in 2004–2012 (23.6 ± 19.8 vs. 9.7 ± 4.5 months). However, the difference was not statistically significant (p = 0.334). In conclusion, early diagnosis and tailored treatments that balance efficacy and adverse events remain the key to obtaining a better outcome in lymphoma-associated HLH.

Background: Palliative chemotherapy is the preferred standard of care for patients with metastatic gastric cancer (mGC). It remains uncertain whether older patients with mGC would benefit from palliative chemotherapy. This study aimed to investigate the clinical impact of palliative chemotherapy in older patients with mGC. Methods: This single-institute, retrospective, and real-world study included 428 patients with mGC between January 2009 and December 2019. Among them, 306 who received palliative chemotherapy were further stratified into 2 groups according to age: ≤70 (n = 236) and >70 (n = 70) years. The clinical demographics, outcomes, and hematologic toxicities of chemotherapy were compared between the 2 groups. Prognostic factors were determined using the Cox proportional hazards model. Results: Of the screened 428 patients, older patients had worse overall survival (OS) than younger patients. Among patients who received chemotherapy (n = 306), patients aged >70 and ⩽70 years had comparable progression-free survival (PFS) and OS. The incidence of severe hematologic toxicity was similar between the 2 groups. The Eastern Cooperative Oncology Group performance status of 2 or more metastatic sites, elevated carbohydrate antigen 19-9 level, high neutrophil-to-lymphocyte ratio (NLR), and undergoing palliative gastrectomy were independent prognostic factors for OS. Notably, age >70 years was not a significant factor for poor OS. Conclusions: Older age of >70 years might not be considered an obstacle to administering palliative chemotherapy to patients with mGC.

Background/Objectives: Older adults with gastric cancer often have poorer prognoses than younger patients. Early recurrence, within two years after curative surgery, is associated with poor outcomes, but its risk factors remain unclear. This study aimed to identify clinicopathological predictors of early recurrence in older patients with stage II/III disease. Methods: We retrospectively reviewed 604 patients with stage II/III gastric cancer who underwent curative surgery from 2009 to 2020. After exclusions, 237 patients aged ≥65 years were analyzed. Clinicopathological variables were compared between those with and without early recurrence, and risk factors were assessed using logistic regression. Results: Among the 237 patients studied, 103 had recurrence following surgery, of whom 72 (69.9%) were categorized as early recurrence. Distant metastasis was the most common pattern (59.7%), followed by peritoneal (45.8%) and locoregional (33.3%) recurrences. Multivariate analysis identified a lymph node ratio (LNR) > 0.17 as an independent risk factor for early recurrence (odds ratio (OR), 5.30; 95% confidence interval (CI), 2.07–13.53; p < 0.001). Conclusions: Early recurrence is frequent among older patients with stage II/III gastric cancer, with distant metastasis as the predominant pattern. An LNR > 0.17 predicts higher recurrence risk. While adjuvant chemotherapy showed a trend toward reduced risk, statistical significance was not reached. Further prospective studies are necessary to confirm these findings.

Background: Vincristine-induced peripheral neuropathy (VIPN), a common side effect of chemotherapy in survivors of non-Hodgkin’s lymphoma (NHL), experience symptoms that may significantly impact quality of life (QoL). The age-related effects on NHL survivors with/without VIPN remain unclear. Purpose: This study was designed to determine the variation in and severity of symptom manifestations in patients in two age groups as well as the effect of age on functional status and QoL. Methods: This cross-sectional study was conducted on 98 NHL survivors in two age groups: the younger group (< 65 years, n = 55) and the older group (≥ 65 years, n = 43). The two assessment tools used were the clinical total neuropathy score and the European Organization for Research and Treatment of Cancer Quality of Life-Core 30. Data analyses were conducted on SPSS (Version 22.0), with the chi-square test used on descriptive statistics and the Fisher’s exact test used on categorical variables. The Kruskal–Wallis test was used to compare differences attributable to age, VIPN status, functional status, and QoL. Results: In the older group, VIPN had a higher severity score compared to the younger group (p = .022), particularly in terms of muscle strength (30.2% vs. 9.1%, p = .009) and deep tendon reflex (60.5% vs. 25.5%, p = .005). In the younger group, NHL patients with VIPN showed poorer physical function, while those in the older group reported poorer QoL. Furthermore, those with VIPN showed poorer cognitive function compared to those without VIPN. Conclusions/Implication for Practice: In terms of older survivors with VIPN, essential measures include early fall prevention education and low-intensity exercise programs to maintain muscle strength and limb coordination and preserve overall QoL. Younger survivors with VIPN require comprehensive support for both physical and emotional challenges, with early understanding and intervention critical. Also, cognitive function impairment should not be neglected in NHL survivors with VIPN symptoms, highlighting the significance of assessing and addressing cognitive health in long-term follow-up plans.

Double-hit (DH) genetics induces a reduction in the complete remission (CR) and, consequently, in poor overall survival (OS) in diffuse large B-cell lymphoma (DLBCL) patients. Unfortunately, DH identification is time-consuming. Here, we retrospectively reviewed 92 newly diagnosed DLBCL patients, stratified them into the DH (n = 14) and non-DH groups (n = 78), and compared their clinical features and outcomes. The results revealed that the DH group had a higher percentage of bulky disease than the non-DH group (64.3% vs. 28.2%; p = 0.013). More patients in the DH group tested positive for double expresser (DE) (50.0% vs. 21.8%; p = 0.044). The three-year OS rates of patients with and without DH were 33.3% and 52.2%, respectively (p = 0.016). Importantly, advance stage and multiple comorbidities were correlated with a high mortality rate in multivariate analysis. Furthermore, by combining DE and the bulky disease, a specificity of 89.7% for DH prediction was achieved. In summary, DH genetics, not DE immunopositivity, could be a factor for an inferior OS in DLBCL. A combination of bulky disease and a positive DE immunophenotype could facilitate DH genetics prediction in newly diagnosed DLBCL patients.