[Prognostic impact of anthracyclines in the treatment of aggressive lymphoma in patients over 70 years]

Med Clin (Barc). 2015 Jun 22;144(12):544-7. doi: 10.1016/j.medcli.2014.04.026. Epub 2014 Aug 8.
[Article in Spanish]

Abstract

Background and objective: The optimal treatment of aggressive non-Hodgkin lymphoma (NHL) in elderly patients remains controversial. We aimed to evaluate the impact of age and use of anthracyclines.

Patients and method: Retrospective analysis of patients with aggressive NHL aged over 70 years old.

Results: One hundred and twenty-eight patients with a median age of 76 years (70-91). Eighty-eight percent received chemotherapy, and 72% received anthracyclines. The overall response rate was 70%, 51% with a complete response (CR)/uncertain complete response and 19% with a partial response (PR). Overall survival (OS) was 28 months (95% confidence interval 18-78). In the diffuse large B-cell lymphoma group, progression-free survival (PFS) and OS were significantly better in patients who achieved CR versus PR. The use of anthracyclines was associated with CR, the international prognostic index (IPI) was associated with both survival and response, and age showed no association.

Conclusions: In patients aged ≥ 70 years with aggressive lymphoma who received chemotherapy, the IPI but not age and the use of anthracyclines showed a prognostic impact. Therefore, in elderly patients with aggressive lymphomas, the use of anthracyclines should be considered and therapeutic decisions should not be based on age exclusively.

Keywords: Age; Anthracyclines; Antraciclinas; Edad; International prognosis index; Linfoma no hodgkiniano; Non-Hodgkin's lymphoma; Índice pronóstico internacional.

Publication types

  • English Abstract

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carmustine / administration & dosage
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Etoposide / administration & dosage
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / mortality
  • Male
  • Methotrexate / administration & dosage
  • Prednisone / administration & dosage
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies
  • Rituximab / administration & dosage
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Cytarabine
  • Rituximab
  • Vincristine
  • Etoposide
  • Doxorubicin
  • Cyclophosphamide
  • Carmustine
  • Prednisone
  • Methotrexate