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Analysis of very elderly (≥80 years) non‐hodgkin lymphoma: impact of functional status and co‐morbidities on outcome
Author(s) -
Nabhan Chadi,
Smith Sonali M.,
Helenowski Irene,
Ramsdale Erika,
Parsons Benjamin,
Karmali Reem,
Feliciano Josephine,
Hanson Britt,
Smith Scott,
McKoy June,
Larsen Annette,
Hantel Andrew,
Gregory Stephanie,
Evens Andrew M.
Publication year - 2012
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 - 10.1111/j.1365-2141.2011.08934.x
Subject(s) - medicine , multivariate analysis , lymphoma , stage (stratigraphy) , activities of daily living , performance status , non hodgkin's lymphoma , retrospective cohort study , progression free survival , geriatrics , oncology , overall survival , physical therapy , paleontology , psychiatry , biology
Summary Data on outcome, prognostic factors, and treatment for very elderly non‐Hodgkin lymphomas (NHL) is sparse. We conducted a multicentre retrospective analysis of NHL patients ≥80 years (at diagnosis) treated between 1999 and 2009. Detailed characteristics were obtained including geriatric syndromes, activities of daily living (ADLs), and co‐morbidities using the Cumulative Illness Rating Scale‐Geriatrics (CIRS‐G). We identified 303 patients: 170 aggressive NHL (84% B cell/16% T cell) and 133 indolent NHL (82% B cell/18% T cell). Median age was 84 years (80–95). A geriatric syndrome was present in 26% of patients, 18% had ≥1 grade 4 CIRS‐G, and 14% had loss of ADLs. At 49‐month median follow‐up, 4‐year progression‐free (PFS) and overall survival (OS) for aggressive NHLs were 31% and 44% respectively (stage I/II: PFS 53% and OS 66%; stage III/IV: PFS 20% and OS 32%; P < 0·0001 and 0·0002, respectively). Four‐year PFS and OS for indolent NHL were 44% and 66% respectively, regardless of stage. Multivariate regression analysis identified two key factors that predicted inferior PFS and OS for both NHL groups: lack of CR and loss of ADLs. Prospective studies for very elderly NHL that incorporate geriatric tools, especially ADLs, are warranted.