Analysis of very elderly (≥80years) non-hodgkin lymphoma: Impact of functional status and co-morbidities on outcome

Chadi Nabhan*, Sonali M. Smith, Irene Helenowski, Erika Ramsdale, Benjamin Parsons, Reem Karmali, Josephine Feliciano, Britt Hanson, Scott Smith, June Mckoy, Annette Larsen, Andrew Hantel, Stephanie Gregory, Andrew M. Evens

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

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 ≥80years (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 84years (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.

Original languageEnglish (US)
Pages (from-to)196-204
Number of pages9
JournalBritish Journal of Haematology
Volume156
Issue number2
DOIs
StatePublished - Jan 1 2012

Keywords

  • Co-morbidities
  • Elderly
  • Functional status
  • Geriatric syndromes
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology

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