在免疫化疗时代，老年患者诊断为弥漫大B细胞淋巴瘤（DLBCL）的长期预后数据很少。在这个人群和长期内，其他死因是一个需要考虑的重要竞争风险。使用临床试验数据和相对生存方法，我们估计了10年净生存率（NS），并描述了DLBCL直接或间接导致过量死亡危险度（EMH），随着时间和主要预后因素的变化灵活地建模。 10年NS为65％[59; 71]。使用灵活建模，我们发现EMH在诊断后急剧降低。 '性能状态'，'多个非淋巴瘤部位数量'和血清'乳酸脱氢酶'这些变量即使在其他重要变量调整后也与EMH强烈相关。在整个人群中，EMH在10年后非常接近于零，因此与一般人口相比，DLBCL患者长期内不会经历增加的死亡率。多个非淋巴瘤部位数量是诊断后重要的预后因素，这表明它与一个重要但未测量的预后因素相关，导致这种选择效应随时间而变。 © 2023年英国血液学会和约翰威立出版社有限公司。

In the era of immunochemotherapy, data on the long-term prognosis of elderly patients diagnosed with a diffuse large B-cell lymphoma (DLBCL) are scarce. In this population and on the longer term, other-cause mortality is an important competing risk that needs to be accounted for. Using clinical trial data and relative survival approaches, we estimated the 10-year net survival (NS) and we described the excess mortality hazard (EMH) due (directly or indirectly) to the DLBCL, over time and according to main prognosis factors using flexible regression modelling. The 10-year NS was 65% [59; 71]. Using the flexible modelling, we showed that the EMH decreases steeply after diagnosis. The variables 'performance status', 'number of extra-nodal sites' and the serum 'lactate dehydrogenase' were strongly associated with the EMH, even after adjustment on other important variables. EMH is very close to zero at 10 years for the whole population, so DLBCL patients do not experience an increased mortality compared to the general population in the long term. The number of extra-nodal sites was an important prognostic factor shortly after diagnosis, suggesting that it is correlated with an important but unmeasured prognostic factor that would lead to this selection effect over time.© 2023 British Society for Haematology and John Wiley & Sons Ltd.