Analysis for clinicopathological features, therapy and prognosis of 30 elderly patients with non-Hodgkin's lymphoma.
10.7534/j.issn.1009-2137.2013.06.018
- Author:
Hai-Tao WANG
1
;
Bo YANG
1
;
Li-Li CAI
2
;
Hai-Hong RAN
1
;
Wen-Ying ZHANG
1
;
Hong-Li ZHU
1
;
Yang YANG
1
;
Su-Xia LI
1
;
Hui FAN
1
;
Xiao-Hua CHI
3
;
Rui-Li YU
1
;
Feng ZHANG
4
;
Bao-Ling LI
1
;
Jie LIN
1
;
Bing ZHAI
1
;
Shan-Qian YAO
1
;
Xue-Chun LU
5
Author Information
1. Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China.
2. Department of Geriatric Laboratorial Medicine, Chinese PLA General Hospital, Beijing 100853, China.
3. Department of Pharmacy, The Second Artillery General Hospital, Beijing 100800, China.
4. Beijing Institute of Genomics, Chinese Academy of Sciences, Beijing 100029, China.
5. Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing 100853, China. E-mail: luxuechun@126.com.
- Publication Type:Journal Article
- MeSH:
Aged;
Aged, 80 and over;
Female;
Humans;
Lymphoma, Non-Hodgkin;
diagnosis;
pathology;
therapy;
Male;
Middle Aged;
Prognosis;
Retrospective Studies;
Treatment Outcome
- From:
Journal of Experimental Hematology
2013;21(6):1464-1470
- CountryChina
- Language:Chinese
-
Abstract:
The purpose of this study was to explore the clinicopathological features, therapy and prognostic factors of elderly patients with non-Hodgkin's lymphoma (NHL). The clinical data including general clinical characteristics, pathological features, chemotherapy selection and treatment response of 30 patients with NHL in our hospital from January 2003 to December 2012 were analyzed retrospectively. The survival was analyzed by using Kaplan-Meier methods, and the prognosis was evaluated by COX regression multivariate analysis model. The clinical parameters selected include age, Ann Arbor stage, international prognostic index (IPI), B symptom and lactate dehydrogenase (LDH) levels. The results showed that all the patients suffered from underlying disease, and the cardiovascular disease (hypertension, coronary heart disease, arrhythmia) is the most common, and minority (8/30) combined with secondary tumor, the 63% (19/30) cases had B symptoms at diagnosis. only 2 cases were diagnosed as T-cell lymphoma; the 93% (28/30) cases combined with B-cell lymphoma, 57% (17/28) of them combined with diffuse large B-cell lymphoma. Ann-Arbor stage ≤ IIwas 37% (11/30);10(37%) patient's IPI score was ≤ 2, and 67% (20/30) was scored 3-5; 13(43%) patient's serum LDH level was abnormal. Modified R-CHOP chemotherapy was given individually on the basis of clinical features. The patients achieved complete remission, partial remission, stable disease, or progressive disease accounted for 14 (46.7%), 13 (43.3%), 1 (3.3%), and 2 (6.7%), respectively; the total reaction rate was 90% after 4 cycles of chemotherapy; the overall survival (OS) rate at 1 and 2 years was 73.3% and 43.3%, and progression-free survival (PFS)rate at 0.5 and 1 years was 62.2% and 54.9%; multivariate analysis by COX regression showed that B symptoms and Ann-Arbor stage were independent factors (P = 0.014, 0.039; RR = 6.678, 4.939, respectively) affecting the OS of elderly NHL, and IPI score affected PFS independently. It is concluded that elderly patients with NHL usually are of late stage at newly diagnosis and have suffered from underlaying diseases. Besides strengthening supportive treatment, modified R-CHOP chemotherapy should be given individually according to different prognosis. B symptoms and Ann-Arbor stage >II are indicators for poor prognosis of elderly NHL.
