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Non-Hodgkin’s lymphoma in the elderly. Age is not always an adverse prognostic factor

Linfomas no Hodgkin en el anciano. La edad no es siempre un factor de mal pronóstico

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Abstract

A retrospective study analyzing non-Hodgkin's lym-phoma (NHL) diagnosed in patients in our center above 65 years of age between the years 1977–1991 is reported. Histological classification has been completed following the criteria of the Working Formulation. Of 521 patients, 427 were candidates for evaluation. Those above 65 years of age comprised the subject of our study, with a total of 95 cases.

Population: 43/52 male/female, 47 intermediate-grade NHL, 38 low-grade NHL, Ann Arbor stages I–II/III–IV 36/59, performance status (PS) 0-1/2-3 39/56, B symptoms yes/no 47/48, lactic dehydrogenase (LDH) normal/high 33/62, albumin normal/low 75/20, Cu normal/high 44/37 (the rest not available), B2 microglobuline normal/high 17/11 (the rest not available), tumor burden (MD Anderson) high/intermediate/low 41/28/26.

The median range of cause specific survival was 30 months (50 for the low-grade NHL, 17 for the intermediate-grade). Significant prognostic factors: Histological grade (low versus high and intermediate), PS 0/1 versus 2/3, presence versus absence of B symptoms, normal versus high LDH, tumor burden (low versus high and intermediate). There is no significant statistical difference between elderly patients and young patients with a poor PS, phases I and IV, low albumin level and high and low tumor burden. Age as an adverse prognostic factor is evident in patients with a strong PS, phases II and III, normal albumin and intermediate tumor burden.

The characteristics and prognostic factors of elderly patients with NHL are similar to those of the young. Age does not always function as an independent prognostic factor; age has no effect on groups with favorable or unfavorable prognostic factors and it is in the intermediate prognostic groups in which age plays a part in survival.

Resumen

Hemos analizado de forma retrospectiva los pacientes diagnosticados de linfoma no Hodgkin (LNH) mayores de 65 años en nuestra institución entre los años 1977–1991. La clasificación histológica empleada sigue los criterios de laWorking Formulation. De 521 patients, 427 fueron candidatos para la revisión; los 95 mayores de 65 años son el objeto de nuestro estudio. Población: 43/52 hombres/mujeres, 47 LNH de grado intermedio, 38 LNH de bajo grado, estadios de Ann Arbor I–II/III–IV 36/59, PS 0-1/2-3 39/56, síntomas B si/no 47/48, LDH normal/elevada 33/62, albúmina normal/baja 75/20, cobre normal/elevado 44/37 (no disponible en el resto), B2 microglobulina normal/elevada 17/11 (no disponible en el resto), masa tumoral del MD Anderson: Alta/intermedia/ baja 4.1/28/26. La mediana de superviencia causa-específica fue de 30 meses (50 meses en los LNH de bajo grado y 17 meses en los de grado intermedio). Factores pronósticos significativos fueron: grado histológico (bajo frente a intermedio y alto), PS 0/1 frente 2/3, presencia frente a ausencia de síntomas B, LDH normal frente a elevada, carga tumoral del MD Anderson baja frente a alta e intermedia. No hubo diferencias estadísticamente significativas entre los pacientes ancianos y jóvenes con pobre PS, estadios I y IV, albúmina baja y cargas tumorales alta y baja. La edad empeora el pronóstico de los pacientes con PS intermedios, estadios II y III, albúmina normal y carga tumoral intermedia.

Las características clínicas y los factores pronósticos de los pacientes ancianos con LNH son similares a las de los pacientes jóvenes. La edad no se comporta siempre como un factor pronóstico independiente. En los grupos con otros factores de buen o mal pronótico la influencia de la edad se diluye y ésta se manifiesta en los grupos con pronóstico intermedio.

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  1. Department of Medical Oncology, Hospital Universitario La Fe, Avda. Campanar, 21, 46009, Valencia

    Ángel Segura Huerta, José Gómez-Codina, Miguel Pastor Borgoñón, Ana Yuste Izquierdo, Pedro López-Tendero, Regina Gironés Sarrió, José A. Pérez-Fidalgo & Constantino Herranz Fernández

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  1. Ángel Segura Huerta
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  2. José Gómez-Codina
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  3. Miguel Pastor Borgoñón
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  4. Ana Yuste Izquierdo
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  5. Pedro López-Tendero
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Huerta, Á.S., Gómez-Codina, J., Borgoñón, M.P. et al. Non-Hodgkin’s lymphoma in the elderly. Age is not always an adverse prognostic factor. Rev Oncol 4, 436–442 (2002). https://doi.org/10.1007/BF02719121

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