Thieblemont C, Grossoeuvre A, Houot R, Broussais-Guillaumont F, Salles G, Traullé C, Espinouse D, Coiffier B
Département d'Hématologie Clinique, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Louis, Institut Universitaire d'Hématologie, Paris.
Ann Oncol. 2008 Apr;19(4):774-9. doi: 10.1093/annonc/mdm563. Epub 2007 Dec 6.
Non-Hodgkin's lymphoma (NHL) in patients older than 80 years is not a rare disease and treatment strategies are often difficult because of associated comorbidities.
We entered 205 NHL patients older than 80 years treated in a single institution in a retrospective analysis to describe clinical presentation and outcome and to identify specific prognostic factors.
The median age was 83 years, and 91% of the cases were B-cell lymphomas consisting mainly of diffuse large B-cell lymphoma and marginal zone lymphoma. Among patients presenting comorbidities (87%), Charlson index was low in almost half of the patients (43%). Patients did not receive any treatment or received corticosteroids alone in 15%, surgery, radiotherapy, or monochemotherapy in 35%, polychemotherapy without anthracycline in 18%, and anthracycline based in 32%. Median overall survival was of 2.2 years. Main reason for death was disease progression (57%). Independent prognostic factors of survival were poor performance status (P < 10(-4)) and high lactate dehydrogenase level (P < 10(-5)). Comorbidities were not found to influence survival.
Very elderly NHL patients showed similar features and prognostic factors than younger patients. Death was related mainly to the disease, meaning that these patients should be more frequently treated with standard treatments.
80岁以上患者的非霍奇金淋巴瘤（NHL）并非罕见疾病，由于合并症，治疗策略往往颇具难度。
我们对在单一机构接受治疗的205例80岁以上NHL患者进行回顾性分析，以描述临床表现和预后，并确定特定的预后因素。
中位年龄为83岁，91%的病例为B细胞淋巴瘤，主要包括弥漫性大B细胞淋巴瘤和边缘区淋巴瘤。在存在合并症的患者中（87%），近一半患者（43%）的查尔森指数较低。15%的患者未接受任何治疗或仅接受了皮质类固醇治疗，35%的患者接受了手术、放疗或单一化疗，18%的患者接受了不含蒽环类药物的联合化疗，32%的患者接受了含蒽环类药物的联合化疗。中位总生存期为2.2年。死亡的主要原因是疾病进展（57%）。生存的独立预后因素是体能状态差（P < 10⁻⁴）和乳酸脱氢酶水平高（P < 10⁻⁵）。未发现合并症会影响生存。
高龄NHL患者与年轻患者表现出相似的特征和预后因素。死亡主要与疾病相关，这意味着这些患者应更频繁地接受标准治疗。
