Background:Elderly patents with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients,and the optimal treatment strategy for this group remains controversial.We conducted a retrospective analysis to investigate the clinical features and outcomes of elderly patients (＞60 years) and to assess the impact of clinical and molecular factors on outcome in this age group.Methods:From April 2006 to December 2012,a total of 349 elderly patients with DLBCL from the National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,and Peking Union Medical College were included in this analysis.Patients were further divided into two age groups (61-69 years and ≥70 years).We compared clinical characteristics and outcomes between groups.Results:Of 349 total patients,204 (58.5％) were aged 61 to 69 years,and 145 (41.5％) patients were aged 70 years or older.Except for the East Cooperative Oncology Group performance status,clinical characteristics were comparable between the two groups.With a median follow-up of 82 (range,1-129) months,the 5-year overall survival (OS) and progression-free survival (PFS) rates were 51.9％ and 45.8％,respectively.The 5-year OS rates for patients aged 61 to 69 years and those over 70 years were 58.3％ and 42.8％ (P =0.007),respectively,and the 5-year PFS rates were 51.0％ and 38.6％ (P =0.034).Treatment regimens including rituximab provided a higher 5-year OS rate (63.1％ vs.37.1％,P ＜ 0.001) and PFS rate (56.6％ vs.31.8％,P ＜ 0.001) than chemotherapy alone.For patients aged 61 to 69 years,chemotherapy plus rituximab resulted in a higher 5-year OS rate (66.7％ vs.46.4％,P =0.002) and PFS rate (60.0％ vs.38.1％,P =0.002) than chemotherapy alone.For patients aged ≥70 years,there was a marked survival advantage in patients who received chemotherapy plus rituximab (5-year OS rate:57.7％ vs.25.4％,P ＜ 0.001;5-year PFS rate:51.3％ vs.23.9％,P ＜ 0.001) compared with that seen in those who received chemotherapy alone.Multivariate analysis established that stage Ⅲ/Ⅳ disease,elevated lactate dehydrogenase (LDH),initial treatment,and chemotherapy with rituximab were independent risk factors for 5-year OS,and stage Ⅲ/Ⅳ disease,elevated LDH,and chemotherapy with rituximab were independent risk factors for 5-year PFS for elderly patients with DLBCL.Conclusions:In comparison to patients aged 61 to 69 years,those aged ≥70 years have poorer survival.Prolonged survival is obtainable with rituximab,cyclophosphamide,doxorubicin,vincristine,and prednisone (R-CHOP)-like in elderly Chinese patients in all age groups,indicating that the R-CHOP-like regimen should be considered for this population,even for those aged 70 years or older.