Survival outcomes among Thai, elderly, Non-Hodgkin lymphoma patients: a 5-year cohort study
Keywords:
clinicopathological features, elderly, Non-Hodgkin lymphoma, SurvivalAbstract
Objectives: The number of elderly patients with nonHodgkin lymphoma (NHL) has increased in recent years because most countries are facing an aging society. This study aimed to compare the baseline clinical characteristics, treatments, and clinical outcomes of younger and older patients with NHL.
Methods: This 5-year, single-center study was conducted among newly diagnosed patients with NHL between January 1, 2013 and December 31, 2017 at Vachira Phuket Hospital, Phuket, Thailand. The clinical features, initial laboratory findings, histopathological findings, stagings, treatments, and clinical outcomes were recorded.
Results: A total of 105 NHL cases were diagnosed during the study period. Their mean age was 57 ± 14.4 years, with a male predominance. Two thirds of the patients were aged under 65. The most common NHL subtype was diffuse large B-cell lymphoma (61.5%), followed by follicular lymphoma (12.5%) and marginal zone B-cell lymphoma (12.5%). Higher proportions of low international prognostic index scores and better Eastern Cooperative Oncology Group performance statuses were shown more by younger patients than the elderly group. The results revealed 3-year overall survival rates of 57% and 35% for the younger and older groups, respectively, with no significant difference in their CR rates (59.2% vs. 49.2%, p = 0.199; OR 2.07, CI 0.68-6.36).
Conclusions: Although the distribution of the lymphoma subtypes among the younger and older patients was quite similar, the survival outcome of the elderly group was poor.
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References
2. Coiffier B, Lepage E. Prognosis of aggressive lymphomas: a study of five prognostic models with patients included in the LNH-84 regimen. Blood. 1989;74:558-64.
3. Thieblemont C, Coiffier B. Lymphoma in older patients. J Clin Oncol. 2007;25:1916-23.
4. Maartense E, Hermans J, Kluin-Nelemans JC, Kluin PM, Van Deijk WA, Snijder S, et al. Elderly patients with non-Hodgkin’s lymphoma: population-based results in the Netherlands. Ann Oncol. 1998;9:1219-27.
5. Campo E, Swerdlow SH, Harris NL, Pileri S, Stein H, Jaffe ES. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood. 2011;117:5019-32.
6. Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol. 1989;7:1630-6.
7. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912-9.
8. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25:579-86.
9. Hazarika M, Iqbal A, Krishnatreya M, Sharma JD, Bhuyan C, Saikia BJ, et al. Adult Non Hodgkin’s Lymphoma patients: experience from a tertiary care cancer centre in north east India. Asian Pac J Cancer Prev. 2015; 16, 2879-81.
10. Carbone A, Volpe R, Gloghini A, Trovo M, Zagonel V, Tirelli U, et al. Non-Hodgkin’s lymphoma in the elderly. I. Pathologic features at presentation. Cancer 1990;66:1991-4.
11. The Non-Hodgkin‘s Lymphoma Pathologic Classification Project. National Cancer Institute sponsored study of classification of non-Hodgkin‘s lymphomas: summary and description of a working formulation for clinical usage. Cancer. 1982;49:2112-35.
12. Maartense E, Hermans J, Kluin-Nelemans JC, Kluin PM, Van Deijk WA, Snijder S, et al. Elderly patients with non-Hodgkin‘s lymphoma: Population-based results in the Netherlands. Ann Oncol. 1998;9:1219-27.
13. Fratino L, Bernardi D. European experiences on aggressive non-Hodgkin’s lymphoma in elderly patients. Crit Rev Oncol Hematol. 2004;51:229-40.
14. Varoczy L, Danko A, Simon Z, Gergely L, Ress Z, Illes A. Malignant lymphomas in the elderly: a single institute experience highlights future directions. Arch Gerontol Geriatr. 2007;45:43-53.
15. Perry AM, Diebold J, Nathwani BN, MacLennan KA, Müller- Hermelink HK, Bast M, et al. Non-Hodgkin lymphoma in the developing world: review of 4539 cases from the International Non-Hodgkin Lymphoma Classification Project. Haematologica. 2016;101:1244-50.
16. Thieblemont C, Grossoeuvre A, Houot R, Broussais-Guillaumont F, Salles G, Traulle C, et al. Non-Hodgkin’s lymphoma in very elderly patients over 80 years. A descriptive analysis of clinical presentation and outcome. Ann Oncol. 2008;19:774-9.
17. Bairey O, Benjamini O, Blickstein D, Elis A, Ruchlemer R. Non-Hodgkin’s lymphoma in patients 80 years of age or older. Ann Oncol. 2006;17:928-34.
18. Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002;346:235-42.
