Presented in part at the 52nd Annual Meeting of the American Society of Hematology (ASH) in Orlando, FL, December 2010. Presented also in part at the 47th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago, IL, June 2011.
Analysis of very elderly (≥80 years) non-hodgkin lymphoma: impact of functional status and co-morbidities on outcome
Article first published online: 16 NOV 2011
© 2011 Blackwell Publishing Ltd
British Journal of Haematology
Volume 156, Issue 2, pages 196–204, January 2012
How to Cite
Nabhan, C., Smith, S. M., Helenowski, I., Ramsdale, E., Parsons, B., Karmali, R., Feliciano, J., Hanson, B., Smith, S., McKoy, J., Larsen, A., Hantel, A., Gregory, S. and Evens, A. M. (2012), Analysis of very elderly (≥80 years) non-hodgkin lymphoma: impact of functional status and co-morbidities on outcome. British Journal of Haematology, 156: 196–204. doi: 10.1111/j.1365-2141.2011.08934.x
- Issue published online: 22 DEC 2011
- Article first published online: 16 NOV 2011
- Received 23 August 2011; accepted for publication 3 October 2011
- non-Hodgkin lymphoma;
- geriatric syndromes;
- functional status;
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.