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Treatment results of aggressive B non‐Hodgkin's lymphoma in advanced age considering comorbidity
Author(s) -
Sonnen Ruth,
Schmidt WolfPeter,
Kuse Rolf,
Schmitz Norbert
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03896.x
Subject(s) - medicine , comorbidity , cyclophosphamide , international prognostic index , prednisone , diffuse large b cell lymphoma , retrospective cohort study , chop , lymphoma , stage (stratigraphy) , surgery , gastroenterology , oncology , chemotherapy , paleontology , biology
Summary. The aim of this retrospective single institution study was to investigate the long‐term outcome of sequential chemotherapy (CHT) and radiotherapy (RT) in patients ≥ 70 years old, considering the International Prognostic Index (IPI) for high‐grade non‐Hodgkin's lymphoma (NHL) and comorbidity. The study involved 106 patients aged 70 years and above, treated between 1986 and 1998, for diffuse large B‐cell NHL (DLBCL); 57% had localized disease (stage I or II) and 43% had advanced disease (stage III or IV). All patients received four to six cycles of CHOP (cyclophosphamide, hydroxy‐daunorubicin, oncovin, prednisone) CHT at 14–21 d intervals, followed in 69 cases by extended‐field or involved‐field RT. Complete response rate was 65%; overall survival probability at 5 years was 41% in all stages. Five‐year survival was 62% in patients with localized and 12% in advanced disease. There were 3% treatment‐related deaths. The 5‐year survival rate was 70% in patients with IPI low risk, 46% with low‐intermediate risk, 28% with high‐intermediate risk and 0% with high risk. Patients with cardiac problems and advanced disease were more susceptible to treatment‐related toxicity. Patients with hypertension showed a high rate of vinca alkaloid‐associated polyneuropathy. Most patients with localized DLBCL achieved long‐term remission after CHT and RT regimens despite advanced age and frequent comorbidities. Advanced disease increased the risk for treatment‐related complications and efficacy of treatment seemed limited.