TY - JOUR
T1 - Analysis of very elderly (≥80years) non-hodgkin lymphoma
T2 - Impact of functional status and co-morbidities on outcome
AU - Nabhan, Chadi
AU - Smith, Sonali M.
AU - Helenowski, Irene
AU - Ramsdale, Erika
AU - Parsons, Benjamin
AU - Karmali, Reem
AU - Feliciano, Josephine
AU - Hanson, Britt
AU - Smith, Scott
AU - Mckoy, June
AU - Larsen, Annette
AU - Hantel, Andrew
AU - Gregory, Stephanie
AU - Evens, Andrew M.
PY - 2012/1
Y1 - 2012/1
N2 - 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.
AB - 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.
KW - Co-morbidities
KW - Elderly
KW - Functional status
KW - Geriatric syndromes
KW - Non-Hodgkin lymphoma
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U2 - 10.1111/j.1365-2141.2011.08934.x
DO - 10.1111/j.1365-2141.2011.08934.x
M3 - Article
C2 - 22084970
AN - SCOPUS:84155180784
SN - 0007-1048
VL - 156
SP - 196
EP - 204
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 2
ER -