Clinical Prognostic Factors and Treatment Outcome of Aggressive Non-Hodgkin's Lymphoma in Elderly Patients.
- Author:
Jung Hye CHOI
1
;
Myung Ju AHN
;
Mo Ran KI
;
Ho Suk OH
;
Young Yuel LEE
;
Il Young CHOI
;
In Soon KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Hanyang University, Korea. ahnmj@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Malignant lymphoma;
Prognostic factors;
Aggressive lymphoma;
Old age
- MeSH:
Aged*;
Burkitt Lymphoma;
Drug Therapy;
Follow-Up Studies;
Humans;
Lymphoma;
Lymphoma, Non-Hodgkin*;
Male;
Multivariate Analysis;
Survival Rate;
T-Lymphocytes;
Treatment Outcome*
- From:Cancer Research and Treatment
2001;33(4):324-328
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL). MATERIALS AND METHODS: We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000. RESULTS: The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001). CONCLUSION: In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.
