Comprehensive Geriatric Evaluation in Elderly Patients With Lymphoma: Feasibility of a Patient-Tailored Treatment Plan

Bernardi, Daniele; Milan, Isabella; Balzarotti, Monica; Spina, Michele; Santoro, Armando; Tirelli, Umberto

doi:10.1200/jco.2003.99.210

Cited by 27 publications

(11 citation statements)

References 7 publications

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“…Although comprehensive geriatric assessment [18] had been applied in the recent clinical trials targeting the haematological malignances in elderly patients, the outcome is still disappointing [19]. The dose limitation of drugs for chemotherapy and the intolerance of elderly patients to chemotherapy are major factors resulting in the unfavourable outcome.…”

Section: Discussionmentioning

confidence: 99%

Repeated transfusions of autologous cytokine‐induced killer cells for treatment of haematological malignancies in elderly patients: a pilot clinical trial

Yang

et al. 2011

Hematological Oncology

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The elderly population is susceptible to haematological malignancies, and these elderly patients are intolerant to cytotoxic drugs. Therefore, the exploration of a safe and reliable strategy exclusive of chemotherapy is critical in improving the prognosis of elderly patients with haematological malignancies. We evaluated the safety and the efficacy of autologous cytokine-induced killer (CIK) cells combined with recombinant human interleukin 2 (rhIL-2) in the treatment of haematological malignancies in elderly patients. Peripheral blood mononuclear cells were isolated from 20 elderly patients with haematological malignancies, then augmented by priming with interferon gamma, rhIL-2 and CD3 monoclonal antibody. The autologous CIK cells (2-3 × 10(9)) were transfused back to patients, followed by a subcutaneous injection of IL-2 (1 mU/day) for 10 consecutive days. The regimen was repeated every 4 weeks. The host cellular immune function, tumour-related biological parameters, imaging characteristics, disease condition, quality of life and survival time were assessed. Fourteen patients received 8 cycles of transfusion and 6 received 4 cycles. No adverse effects were observed. The percentages of CD3(+), CD3(+) CD8(+) and CD3(+) CD56(+) cells were significantly increased (p < 0.05), and the levels of serum β2 microglobulin and lactate dehydrogenase (LDH) were markedly decreased (p < 0.05) after autologous CIK cell transfusion. Cancer-related symptoms were profoundly alleviated, as demonstrated by the improved quality of life (p < 0.01). Complete remission was observed in 11 patients, persistent partial remission in 7 patients and stable disease in 2 patients. At the end of follow-up, the mean survival time was 20 months. Transfusion with autologous CIK cells plus rhIL-2 treatment is safe and effective for treating haematological malignancies in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Repeated transfusions of autologous cytokine‐induced killer cells for treatment of haematological malignancies in elderly patients: a pilot clinical trial

Yang

et al. 2011

Hematological Oncology

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“…Recently, a new approach has been presented for elderly patients affected by NHL, allowing a patient-tailored treatment with the goal of maintaining a balance between the desire to cure the patient and guaranteeing a good quality of life [60]. This approach, based on a comprehensive geriatric evaluation (CGA) including the ADL and IADL scales, has been demonstrated suitable and highly effective and does not exclude any elderly patient from potentially curative chemotherapy.…”

Section: General Considerationsmentioning

confidence: 99%

European experiences on aggressive non-Hodgkin?s lymphoma in elderly patients

Fratino

Bernardi

2004

Critical Reviews in Oncology/Hematology

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“…2002). Trials in which frail patients start with lower doses of chemotherapy and only in case of substantial improvement follow usual treatments are ongoing (Bernardi et al . 2003).…”

Section: Frailtymentioning

confidence: 99%

“…For example, in the presence of chemosensitive tumours such as high grade lymphomas, an attempt of monochemotherapy may still be proposed to chemo-naive frail patients . Trials in which frail patients start with lower doses of chemotherapy and only in case of substantial improvement follow usual treatments are ongoing (Bernardi et al 2003). Some authors have suggested a grading of the severity of frailty (Wymenga et al 2001), which does not appear wise in light of the urgent necessity to implement stringent algorithms in geriatric clinical trials.…”

Section: Frailtymentioning

confidence: 99%

Multidimensional geriatric evaluation in elderly cancer patients: a practical approach

Basso¹,

Monfardini

2004

Eur J Cancer Care

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Management of cancer in the elderly population is currently perceived as one of the major challenges for clinical research in medical oncology. Multidisciplinary evaluation of the malignant disease and multidimensional assessment of the host represent the key element for correct decision making. Standard methods developed by pioneer geriatric oncologists will be summarized in this review, along with some practical suggestions on when and how they should be employed. Future perspectives concerning some critical issues in multidimensional geriatric assessment will be discussed as well.

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Comprehensive Geriatric Evaluation in Elderly Patients With Lymphoma: Feasibility of a Patient-Tailored Treatment Plan

Cited by 27 publications

References 7 publications

Repeated transfusions of autologous cytokine‐induced killer cells for treatment of haematological malignancies in elderly patients: a pilot clinical trial

Repeated transfusions of autologous cytokine‐induced killer cells for treatment of haematological malignancies in elderly patients: a pilot clinical trial

European experiences on aggressive non-Hodgkin?s lymphoma in elderly patients

Multidimensional geriatric evaluation in elderly cancer patients: a practical approach

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