title: Role of anemia in survival of patients with elderly aggressive non-Hodgkin's lymphoma after chemotherapy.
abstract: Baseline anemia is a relevant prognostic factor in the overall population of non-Hodgkin's lymphoma (NHL) patients, and studies focusing on elderly NHL are awaited. We conducted a pooled analysis of a cohort of comparable patients enrolled (1993 - 2001) in three multicenter clinical trials on use of a MACOP-B-like regimen (VNCOP-B) for front-line treatment of elderly aggressive NHL. Models of Cox's proportional hazards regression analysis of prognostic value of pre-/post-treatment hemoglobin values in terms of 5-year overall survival included age, sex, initial tumor staging and response to treatment. Of the 168 patients screened, 16 were excluded due to missing data or lack of 5-year follow-up. In addition to achievement of complete/partial remission (adjusted relative risk [RR], 0.215; p = 0.0001) and advanced stage (II-IV vs. I - II; adjusted RR, 1.55; p = 0.0023), post-treatment hemoglobin values were an independent predictor of survival (adjusted RR per 1-g/dL increment, 0.76; p = 0.0041). In the present analysis, pretreatment hemoglobin values were associated with only marginal risk reduction (adjusted RR per 1-g/dL increment, 0.985; p = 0.049). Post-treatment hemoglobin values appear to provide a strong independent predictor of 5-year survival in elderly aggressive NHL, supporting the potential role of anemia correction in this group of patients.
authors.affiliation: Institute of Hematology and Medical Oncology Seràgnoli, University of Bologna, Bologna. plzinzo@med.unibo.it
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.forename: Monica
authors.initials: M
authors.lastname: Tani
authors.forename: Lapo
authors.initials: L
authors.lastname: Alinari
authors.forename: Anna Lia
authors.initials: AL
authors.lastname: Molinari
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stefoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Visani
authors.forename: Patrizia
authors.initials: P
authors.lastname: Gentilini
authors.forename: Luciano
authors.initials: L
authors.lastname: Guardigni
authors.forename: Mariapaola
authors.initials: M
authors.lastname: Fina
authors.forename: Michele
authors.initials: M
authors.lastname: Baccarani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D015996:Survival Rate