Elderly patients with aggressive non-Hodgkin's lymphoma: disease presentation, response to treatment, and survival--a Groupe d'Etude des Lymphomes de l'Adulte study on 453 patients older than 69 years.

Bastion, Y.; Blay, J-Y.; Diviné, Marine; Brice, P.; Bron, Dominique; Sebban, Catherine; Blanc, Michel; Tilly, H; Léderlin, P.; Deconinck, Eric; Salles, Bruno César Corrêa; Dumontet, Charles; Brière, Josette; Coiffier, B

doi:10.1200/jco.1997.15.8.2945

Cited by 185 publications

(92 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, of these 12 studies, only 1 directly compared anthracyclinecontaining and non-anthracycline-containing regimens. 10 Two of the 12 studies used mitoxantrone, an anthracenedione originally designed to reduce cardiotoxicity, as a substitute for anthracycline. 11,12 The remaining trials examined the efficacy of reduced-dose regimens, altered chemotherapy schedules, and variations in other regimen components.…”

mentioning

confidence: 99%

Non‐Hodgkin lymphoma in elderly patients

Bai

Yang

Chiou

et al. 2003

Cancer

View full text Add to dashboard Cite

BACKGROUNDThe annual incidence of non‐Hodgkin lymphoma (NHL) has increased over the past two decades in all age groups, including the elderly. Establishing guidelines for proper care for this segment of the population requires further information.METHODSBetween January 1993 and April 2002, 187 consecutive patients with NHL who were age 70 years or older were examined as part of the current study. Potential factors implicated in prognosis were analyzed for indolent lymphoma group and aggressive lymphoma group separately.RESULTSThe median patient age was 75 years (range, 70–90 years), and 83% of the patients examined were male. Fifty‐two patients (28%) had indolent lymphoma, and 135 patients (72%) had aggressive lymphoma. The complete remission rate was 33.3% for patients with indolent lymphoma and 35.9% for patients with aggressive lymphoma. Median overall survival was 41.5 months and 23.7 months for the indolent and aggressive lymphoma groups, respectively. The 1‐year and 5‐year survival rates were 76% and 32%, respectively, for patients with indolent lymphoma and 62% and 29%, respectively, for patients with aggressive lymphoma. Among patients with indolent lymphoma, poor prognosis was correlated with poor performance status (P = 0.0107), advanced disease stage (P = 0.0222), initial bone marrow involvement (P = 0.0069), and age greater than 80 years (P = 0.0486); however, none of these variables remained statistically significant after multivariate Cox regression. Among patients with aggressive lymphoma, the only prognostic factors that remained after multivariate analysis were performance status (P = 0.018) and age greater than 80 years (P = 0.029). For patients who received at least 2 courses of systemic chemotherapy, an anthracycline‐containing regimen did not affect the survival rate in either the indolent lymphoma group (P = 0.81) or the aggressive lymphoma group (P = 0.34). After stratification, it was found that patients with aggressive lymphoma who were in the high‐intermediate‐risk group (as determined by International Prognostic Index [IPI] score) benefited most from the anthracycline‐containing regimen (P = 0.0148).CONCLUSIONSPerformance status was identified as the major prognostic determinant for elderly patients with aggressive NHL. In addition, it was found that an anthracycline‐containing treatment regimen may be especially beneficial for patients in the high‐intermediate‐risk category as determined by IPI score. Cancer 2003;98:1188–95. © 2003 American Cancer Society.DOI 10.1002/cncr.11609

show abstract

mentioning

confidence: 99%

Non‐Hodgkin lymphoma in elderly patients

Bai

Yang

Chiou

et al. 2003

Cancer

View full text Add to dashboard Cite

show abstract

“…This equivalence of survival is despite the fact that the CR rate was less with PMitCEBO and presumably reflects that the earlier response assessment carried out with the shorter duration regimen underestimates the true response rate because of residual necrotic or fibrotic tissue (Surbone et al, 1988;Sweetenham et al, 1991). PMitCEBO is thus a valid alternative to CHOP contrasting with several other curtailed or modified regimens, which appear to be inferior (Meyer et al, 1995;Sonneveld et al, 1995;Bastion et al, 1997;Tirelli et al, 1998;Osby et al, 2003). A decision as to whether to use CHOP or PMitCEBO should therefore be based on the ease of administration and the comparative toxicities of the two regimens.…”

Section: Discussionmentioning

confidence: 92%

“…Advanced age is an independent poor prognostic factor, with inability to tolerate chemotherapy and maintain dose intensity (International NHL Prognostic Factors Project, 1993;NHL Classification Project, 1997;Bastion et al, 1997). Higher treatment-related mortality has also been reported in older patients using the CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) regimen (Armitage and Potter, 1984).…”

mentioning

confidence: 99%

A phase III trial comparing CHOP to PMitCEBO with or without G-CSF in patients aged 60 plus with aggressive non-Hodgkin's lymphoma

et al. 2006

View full text Add to dashboard Cite

The management of older patients with aggressive non-Hodgkin's lymphoma presents a challenge to the physician. Age is a poor prognostic indicator, due to reduced ability to tolerate and maintain dose-intensive chemotherapy. Generally, older patients demonstrate a lower response rate, reduced survival and increased toxicity, although the majority of large randomised trials exclude older patients. This randomised trial was conducted in patients 60 years or over to compare CHOP (cyclophosphamide 750 mg m À2 , doxorubicin 50 mg m À2 , vincristine 1.4 mg m À2 , prednisolone 100 mg) with PMitCEBO (mitoxantrone 7 mg m À2 , cyclophosphamide 300 mg m À2 , etoposide 150 mg m À2 , vincristine 1.4 mg m À2 , bleomycin 10 mg m À2 and prednisolone 50 mg). Due to the myelosuppressive nature of these regimens, patients were also randomised to the addition of G-CSF. The formal results of this trial with long-term follow-up are now reported. Data were analysed to assess efficacy and toxicity. Overall response rate was 84% in the CHOP arm and 83% in the PMitCEBO arm, with overall response rates of 83%

show abstract

“…Their reports demonstrated that the CHOPregimen was well tolerated by patients over 60 years old. Therefore, we prescribed a CHOP-likeregimen as induction chemotherapy, however, the outcome of patients who achieve PR with firstline chemotherapy was still poor in several reports (14,15). The treatment strategy for elderly NHLpatients varies.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Blood Stem Cell Transplantation in Patients Over 65 Years Old with Malignant Lymphoma-Possibility of Early Completion of Chemotherapy and Improvement of Performance Status-

2001

View full text Add to dashboard Cite

Objective After the initial clinical application of peripheral blood stem cell transplantation (PBSCT) in the latter half of the 1980s, the frequency of PBSCTfor nonHodgkin's lymphoma (NHL) has been gradually increasing. At present, PBSCTis an important procedure for treating young patients with NHL.This procedure is now being increasingly used as a part of the chemotherapy regimen for elderly patients. Conclusion Despite the small number of cases, this procedure is beneficial for completing chemotherapy earlier and promoting a good quality of life. (Internal Medicine 40: 471-474, 2001)

show abstract

Elderly patients with aggressive non-Hodgkin's lymphoma: disease presentation, response to treatment, and survival--a Groupe d'Etude des Lymphomes de l'Adulte study on 453 patients older than 69 years.

Abstract: Elderly patients with aggressive lymphoma have an aggressive disease with adverse prognostic parameters at the time of diagnosis. Slightly longer survival was observed for patients treated with an anthracycline-containing regimen.

Cited by 185 publications

References 0 publications

Non‐Hodgkin lymphoma in elderly patients

Non‐Hodgkin lymphoma in elderly patients

A phase III trial comparing CHOP to PMitCEBO with or without G-CSF in patients aged 60 plus with aggressive non-Hodgkin's lymphoma

Peripheral Blood Stem Cell Transplantation in Patients Over 65 Years Old with Malignant Lymphoma-Possibility of Early Completion of Chemotherapy and Improvement of Performance Status-

Contact Info

Product

Resources

About