Non-Hodgkin's lymphoma of the elderly. Prognostic factors and outcome.
The initial features and prognosis of non-Hodgkin's lymphoma (NHL) of the elderly have been variously evaluated in literature. We have examined 190 patients with NHL: most of them received induction therapies containing vincristine, cyclophosphamide and/or anthracyclines (CVP, CHOP, CEOP); age at diagnosis was over 65 for 62 of them (32.63%). Elderly patients had a lower rate of complete remissions, a shorter duration of complete remissions and, consequently, a poorer overall survival. In our patients, prognosis was related also with stage, histology (according to Working Formulation, WF) and performance status at the diagnosis. Elderly patient had not a significantly increased incidence of these unfavourable prognostic factors at the onset. However, patients aged 65 or more received lower doses of drugs during induction therapy (cyclophosphamide: 81%; vincristine: 73%; anthracyclines: 22% of patients under 55). Patients aged 55-65 had induction therapies of intermediate intensity; also proportion of complete remissions and survival were intermediate between the two other groups. Haematological toxicity appeared the most important cause of these reductions: in fact nadirs of neutrophils and platelets during induction therapy were similar in the 3 groups in spite of the different intensity of treatment. Even if statistical correlations are not possible, the incidence of infections has been higher in the elderly.
Rossini
F
F
Cattedra di Patologia medica, Sezione di Ematologia, Ospedale, Monza.
Mingozzi
S
S
Pogliani
E M
EM
Pioltelli
P
P
Lanzi
E
E
Corneo
G
G
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015993:Life Tables; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012074:Remission Induction