title: Disease characteristics, treatment patterns, prognosis, outcomes and lymphoma-related mortality in elderly follicular lymphoma in the United States.
abstract: Data from the National LymphoCare Study (a prospective, multicentre registry that enrolled follicular lymphoma (FL) patients from 2004 to 2007) were used to determine disease characteristics, treatment patterns, outcomes and prognosis for elderly FL (eFL) patients. Of 2650 FL patients, 209 (8%) were aged >80 years; these eFL patients more commonly had grade 3 disease, less frequently received chemoimmunotherapy and anthracyclines, and had lower response rates when compared to younger patients. With a median follow-up of 6.9 years, 5-year overall survival (OS) for eFL patients was 59%; 38% of deaths were lymphoma-related. No treatment produced superior OS among eFL patients. In multivariate Cox models, anaemia, B-symptoms and male sex predicted worse OS (P < 0.01); a prognostic index of these factors (0, 1 or ≥ 2 present) predicted OS [hazard ratio (95% CI): ≥ 2 vs. 0, 4.72 (2.38-9.33); 1 vs. 0, 2.63 (1.39-4.98)], with a higher concordance index (0.63) versus the Follicular Lymphoma International Prognostic Index (0.55). The index was validated in an independent cohort. In the largest prospective US-based eFL cohort, no optimal therapy was identified and nearly 40% of deaths were lymphoma-related, representing baseline outcomes in the modern era.
authors: Department of Medicine Section of Hematology and Oncology, The University of Chicago Comprehensive Cancer Center, Chicago, IL, USA.
authors: Chadi
authors: C
authors: Nabhan
authors: Genentech Inc, South San Francisco, CA, USA.
authors: Michelle
authors: M
authors: Byrtek
authors: Emory University, Atlanta, GA, USA.
authors: Ashish
authors: A
authors: Rai
authors: Genentech Inc, South San Francisco, CA, USA.
authors: Keith
authors: K
authors: Dawson
authors: RTI Health Solutions, Research Triangle Park, NC, USA.
authors: Xiaolei
authors: X
authors: Zhou
authors: University of Iowa, Iowa, IA, USA.
authors: Brian K
authors: BK
authors: Link
authors: University of Rochester, Rochester, NY, USA.
authors: Jonathan W
authors: JW
authors: Friedberg
authors: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors: Andrew D
authors: AD
authors: Zelenetz
authors: Mayo Clinic, Rochester, MN, USA.
authors: Matthew J
authors: MJ
authors: Maurer
authors: Mayo Clinic, Rochester, MN, USA.
authors: James R
authors: JR
authors: Cerhan
authors: Emory University, Atlanta, GA, USA.
authors: Christopher R
authors: CR
authors: Flowers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008224:Lymphoma, Follicular / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: chemotherapy; elderly lymphoma; elderly patients; follicular lymphoma; rituximab