老年和体弱患者侵袭性非霍奇金淋巴瘤的当前治疗选择：血液科医生的实际考量
Current treatment options for aggressive non-Hodgkin lymphoma in elderly and frail patients: practical considerations for the hematologist.
作者信息
Schmittlutz Katrin, Marks Reinhard
机构信息
Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany.
Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, Freiburg im Breisgau 79106, Germany.
出版信息
Ther Adv Hematol. 2021 Mar 3;12:2040620721996484. doi: 10.1177/2040620721996484. eCollection 2021.
Abstract
Treatment decisions for aggressive non-Hodgkin lymphoma in elderly and frail patients still remain challenging. The heterogeneity of elderly patients consists of various physical and psychological states, coexisting comorbidities as well as frailty and socioeconomic status. Comprehensive geriatric assessment in elderly patients is efficient and necessary for risk stratification to identify fit patients without cardiac comorbidities who can tolerate curative treatment with rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) and those who are not suitable for a standard regimen. If anthracycline-containing therapy is not feasible, alternative treatment options have to be carefully evaluated and individual risk factors have to be considered.
摘要
老年和体弱患者侵袭性非霍奇金淋巴瘤的治疗决策仍然具有挑战性。老年患者的异质性包括各种身体和心理状态、并存的合并症以及虚弱和社会经济状况。对老年患者进行全面的老年医学评估对于风险分层是有效且必要的，以便识别出没有心脏合并症、能够耐受利妥昔单抗、环磷酰胺、阿霉素、长春新碱、泼尼松（R-CHOP）根治性治疗的合适患者以及那些不适合标准方案的患者。如果含蒽环类药物的治疗不可行，则必须仔细评估替代治疗方案，并考虑个体风险因素。
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