More than 60% of patients with non-Hodgkin lymphoma (NHL) are age >60 years at presentation. The purpose of this study was to compare the potential risks and benefits of allogeneic hematopoietic cell transplantation (alloHCT) in elderly patients with NHL with younger patients in a large sample, also taking into account comorbidity information. All patients age ≥18 years who had undergone alloHCT from a matched sibling or unrelated donor for NHL between 2003 and 2013 and were registered with the European Society for Blood and Marrow Transplantation were eligible for the study. The primary study endpoint was 1-year nonrelapse mortality (NRM). A total of 3919 patients were eligible and were categorized by age: young (Y), 18 to 50 y (n = 1772); middle age (MA), 51 to 65 y (n = 1967); or old (O), 66 to 77 y (n = 180). Follicular lymphoma was present in 37% of the patients; diffuse large B cell lymphoma, in 30%; mantle cell lymphoma, in 21%, and peripheral T cell lymphoma, in 11%. At the time of alloHCT, 85% of the patients were chemosensitive and 15% were chemorefractory. With a median follow-up of 4.5 years in survivors, NRM at 1 year was 13% for the Y group. 20% for the MA group, and 33% for the O group (P <.001), whereas relapse incidence and overall survival (OS) at 3 years in the 3 groups were 30%, 31%, and 28% (P = .355) and 60%, 54%, and 38% (P <.001), respectively. Multivariable adjustment for confounders, including sex, NHL subset, time from diagnosis, chemosensitivity, donor, and conditioning, confirmed older age as a significant predictor for NRM and OS, but not for relapse risk. Although comorbidity was a significant predictor of NRM in a subset analysis restricted to the 979 patients with comorbidity information available, age retained its significant impact on NRM. In conclusion, our data show that alloHCT in patients age >65 y provides similar NHL control as seen in younger patients but is associated with a higher NRM that is not fully explained by comorbidity. Thus, although alloHCT is feasible and effective in very old patients, the increased NRM risk must be taken into account when assessing the indication for alloHCT for NHL in this age group.

The European Organisation for Research and Treatment of Cancer Quality of Life Multiple Myeloma Questionnaire (EORTC QLQ-MY20) was developed in 1996 to assess health-related quality of life (HRQoL) in patients with multiple myeloma. Since its development new therapies have prolonged survival in patients with myeloma and new combination agents are likely to impact HRQoL outcomes and its measurement.The aim of this review was to explore the use of the QLQ-MY20 and reported methodological issues.An electronic database search was conducted (1996-June 2020) to identify clinical studies/research that used the QLQ-MY20 or assessed its psychometric properties. Data were extracted from full-text publications/conference abstracts and checked by a second rater.The search returned 65 clinical and 9 psychometric validation studies. The QLQ-MY20 was used in interventional (n = 21, 32%) and observational (n = 44, 68%) studies and the publication of QLQ-MY20 data in clinical trials increased over time. Clinical studies commonly included relapsed patients with myeloma patients (n = 15, 68%) and assessed a range of combinations therapies.QLQ-MY20 subscales (disease symptoms [DS], side effects of treatment [SE], future perspectives [FP], body image [BI]) were defined as secondary (n = 12, 55%) or exploratory (n = 7, 32%) trial endpoints, particularly DS (n = 16, 72%) and SE (n = 16, 72%). Validation articles demonstrated that all domains performed well regarding internal consistency reliability (>0.7), test-reset reliability (intraclass correlation coefficient > =0.85), internal and external convergent and discriminant validity. Four articles reported a high percentage of ceiling effects in the BI subscale; all other subscales performed well regarding floor and ceiling effects.The EORTC QLQ-MY20 remains a widely used and psychometrically robust instrument. While no specific problems were identified from the published literature, qualitative interviews are ongoing to ensure new concepts and side effects are included that may arise from patients receiving novel treatments or from longer survival with multiple lines of treatment.

The EORTC QLQ-C30 Summary Score (Summary Score) measures overall health-related quality of life (HRQoL) using 27 of the 30 items of the EORTC QLQ-C30. This systematic review evaluated the Summary Score's use in clinical oncology studies, its construct validity through cross-sectional known-group comparisons, and its responsiveness to change over time compared to the EORTC QLQ-C30 Global Health/Quality of Life (Global Health/QoL) scale. We systematically searched 11 databases for original studies on the Summary Score in adult cancer patients up to April 2024. Data were extracted and cross-checked by two reviewers. We analyzed Cohen's d effect sizes from cross-sectional known-group comparisons and responsiveness analyses of both the Summary Score and Global Health/QoL scale, using a Bland-Altman plot, paired t-tests, and a linear mixed-effects model. A total of 249 studies were included, with 37 % using the Summary Score as a primary patient-reported outcome measure. Only 4 studies formally validated the Summary Score; most employed it to assess HRQoL for varied purposes. Across 29 comparisons from 18 studies, the Summary Score yielded higher effect sizes than the Global Health/QoL scale, confirmed by the mixed-effects model (mean absolute difference = 0.17, p = 0.018). In paired t-tests, this difference was 0.21 (95 % CI 0.04 - 0.38) in cross-sectional known-group comparisons, and 0.07 (95 % CI -0.16 - 0.29) and 0.23 (95 % CI -0.30 - 0.76) for responsiveness within and between groups, respectively. This study indicates that the Summary Score more effectively detects differences in HRQoL than the Global Health/QoL scale. This advantage was most evident in cross-sectional known-group comparisons and, to a lesser extent, in analyses of responsiveness to change between groups. Based on the available evidence, we recommend the Summary Score for assessing overall HRQoL in clinical oncology studies, unless there is a specific, predefined rationale for selecting the Global Health/QoL scale.

Introduction: Belantamab mafodotin (belamaf) was the first BCMA‐targeting immunotherapy licensed in myeloma and was available as monotherapy for a fifth or greater line of treatment. Outcomes for patients in the United Kingdom and the Republic of Ireland potentially differ from those of other regions and may illuminate factors predicting response to therapy.Methods and Results: We performed a retrospective study of patients treated with belamaf monotherapy in the United Kingdom and the Republic of Ireland. In our cohort of 88 patients, we saw an overall response rate (ORR) of 60%, a median progression‐free survival (PFS) of 8.7 months and a median duration of response (DoR) of 15.8 months. The spectrum of adverse events was as expected, with 84% (71/85) of patients experiencing toxicity. Eye‐related adverse events were the most common, affecting 66% (56/85), leading to dose reduction or delay in 41% (35/85) and discontinuation in 6% (5/85). We specifically assessed physician decision‐making in the context of ocular side effects and found a relatively high frequency of the drug being administered despite moderate levels of toxicity.Conclusion: Our cohort's ORR is significantly different from those of the DREAMM‐2 and ‐3 trials and other real‐world studies, though a long‐duration response has been reported in other cohorts. Comparative analysis with other real‐world studies did not reveal any significant factors predictive of ORR. The frequent administration of belamaf to patients with eye disease may well reflect a more pragmatic approach than was originally prescribed in the landmark trials.Trial Registration: The authors have confirmed clinical trial registration is not needed for this submission.