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We studied the impact of CHOP chemotherapy on the quality of life (QoL) of elderly patients with aggressive non-Hodgkin's lymphoma (NHL). 132 patients aged 65 or older, who participated in a randomized, multicenter trial, completed QoL questionnaires (EuroQol-5D, EORTC QLQ-C30 and MFI-20) on 8 predefined time-points before, during and following treatment. At baseline, QoL was significantly better on almost all dimensions in patients with a lower compared to patients with a higher age-adjusted International Prognostic Index (aaPI). During treatment, physical and role functioning and global QoL deteriorated and fatigue increased in the lower aaPI group, whereas QoL of the higher aaPI group remained stable. During follow-up, the QoL was significantly better for patients in complete response (CR) or partial remission (PR) than for patients with progression/relapse. Soon after completion of therapy, the QoL of the lower aaPI group returned to pretreatment levels or better, while patients with higher aaPI showed a significant improvement in QoL compared to baseline levels. The effect of CHOP on the quality of life of elderly patients could be used in counseling this group of patients.

In a phase III randomized, multicenter study, the Germanspeaking Myeloma-Multicenter Group (GMMG) and the DutchBelgian Hemato-Oncology Cooperative Group (HOVON) group investigated the influence of thalidomide (Thal) on the outcome of peripheral blood stem cell (PBSC) collection in multiple myeloma (MM) before peripheral autologous blood stem cell transplantation (ABSCT). We analyzed the data of 398 myeloma patients after induction with Thal, doxorubicin and dexamethasone (TAD) in comparison with vincristine, doxorubicin and dexamethasone (VAD) followed by mobilization with cyclophosphamide, doxorubicin, dexamethasone (CAD) and PBSC collection. Within both the study groups, patients treated with TAD showed to collect significantly fewer CD34 þ cells compared with VAD (GMMG, TAD: median 9.8 Â 10 6 /kg; range 2.0-33.6; VAD: median 10.9 Â 10 6 /kg range 3.0-36.0; P ¼ 0.02) (HOVON, TAD: median 7.4 Â 10 6 /kg; range 2.0-33.0; VAD: median 9.4 Â 10 6 /kg; range 0.0-48.7; P ¼ 0.009). However, engraftment after peripheral autologous stem cell transplantation showed no difference between Thal and VAD groups. We conclude that Thal as a part of induction regimen is associated with better response rates (GMMG-HD3: CR/PR 79%, VAD: CR/PR 58%; HOVON-50: TAD: CR/PR 81%, VAD: CR/PR 61%), but significantly affects the yield of PBSC collection. Nevertheless, the number of total CD34 þ cells collected was sufficient for double autologous transplantation in 82% of the Thal patients, with at least 2.5 Â 10 6 /kg CD34 þ cells.

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