Non-Hodgkin's lymphoma in patients 80 years of age or older.
BACKGROUND
Very elderly patients (> or =80 years old) with non-Hodgkin's lymphoma (NHL) frequently have co-morbid conditions and are generally excluded from clinical trials or even from treatment. The optimal treatment of these patients is unknown.


METHODS
We reviewed the records of 109 patients > or =80 years at diagnosis of NHL (65 F/44 M; median age: 84 years, range; 80-95).


RESULTS
Seventy-eight patients (72%) had aggressive NHL, 25 (23%) had indolent and NHL, eight had unclassified disease. Advanced-stage disease was noted in 54%. Forty patients (39%) had a poor ECOG performance status (PS), and 52 (49%) had an intermediate or high risk International Prognostic Index (IPI). Seventy-nine patients (72%) were treated with chemotherapy and 37 (34%) with radiotherapy. Initial chemotherapy consisted of chlorambucil in 15, oral etoposide in 2, and combination protocol in 62. Only 16% of patients received full-dose therapy, and only 50% completed > or =6 cycles of combination chemotherapy. The overall response rate for the 69 evaluable patients was 84% (complete 56.5%, partial 27.5%). Overall 5-year survival for the whole group was 39%, and median survival time was 26 months.


CONCLUSIONS
A high response rate can be achieved in very elderly NHL patients despite aggressive histology, poor prognostic features, and reduced doses of chemotherapy. Age alone should not be a contraindication to treatment.
Bairey
O
O
Institute of Hematology, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Department of Internal Medicine A, Sapir Medical Center, Kfar Saba, Israel. bernhard.pestalozzi@usz.ch
Benjamini
O
O
Blickstein
D
D
Elis
A
A
Ruchlemer
R
R
D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008228:Lymphoma, Non-Hodgkin / Q000145:classification / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D012984:Software; D016019:Survival Analysis; D017741:Survivors