年龄对非霍奇金淋巴瘤患者特征及临床行为的影响。非霍奇金淋巴瘤分类项目。

Effect of age on the characteristics and clinical behavior of non-Hodgkin's lymphoma patients. The Non-Hodgkin's Lymphoma Classification Project.

出版信息

Ann Oncol. 1997 Oct;8(10):973-8.

Abstract

BACKGROUND

The goals of this study are to describe the frequency, clinical characteristics, and outcome of the different non-Hodgkin's lymphomas according to age.

PATIENTS AND METHODS

Patients included in the recently published analysis of the Non-Hodgkin's Lymphoma Classification Project were analyzed. All patients had their slides reviewed and classified by five independent expert hematopathologists. Lymphomas were classified according to the Revised European American Classification of lymphoid neoplasms. Sufficient data were available on 1283 cases. Five age groups were analyzed: < 35 years, 35-49 years, 50-59 years, 60-69 years, and > or = 70 years.

RESULTS

Few differences were observed between the age groups with regard to lymphoma types and clinical characteristics. Anaplastic large cell lymphoma, Burkitt's lymphoma, and lymphoblastic lymphoma were observed more frequently in patients younger than 35 years, whereas small lymphocytic and lymphoplasmacytoid lymphomas were observed more frequently in patients older than 70 years. Mantle cell lymphoma and marginal zone lymphomas were observed more frequently in middle-aged patients. Poor performance status was more frequent in older patients, as was bone marrow infiltration, whereas spleen involvement was more frequent in younger patients. Young and older patients had a slightly worse age-adjusted International Prognostic Index score (P < 0.01). Complete response rates decreased with age from 68% in the youngest patients to 45% in the oldest patients (P < 0.0001). Median event-free survival and overall survival also decreased with age (P < 0.0001).

CONCLUSIONS

Elderly patients have a poorer outcome than younger patients but age alone is not sufficient to discriminate patients with a poor outcome. However, the histologic type of lymphoma and clinical characteristics may define a subgroup of patients with a poor outcome in each age category.

摘要

背景

本研究的目的是根据年龄描述不同类型非霍奇金淋巴瘤的发病率、临床特征及预后情况。

患者与方法

对近期发表的非霍奇金淋巴瘤分类项目分析中纳入的患者进行分析。所有患者的切片均由五位独立的血液病理专家进行复查和分类。淋巴瘤按照修订的欧美淋巴样肿瘤分类标准进行分类。共有1283例患者有足够的数据。分析了五个年龄组：<35岁、35 - 49岁、50 - 59岁、60 - 69岁以及≥70岁。

结果

在淋巴瘤类型和临床特征方面，各年龄组之间观察到的差异较少。间变性大细胞淋巴瘤、伯基特淋巴瘤和淋巴母细胞淋巴瘤在35岁以下患者中更为常见，而小淋巴细胞淋巴瘤和淋巴浆细胞样淋巴瘤在70岁以上患者中更为常见。套细胞淋巴瘤和边缘区淋巴瘤在中年患者中更为常见。老年患者中身体状况较差以及骨髓浸润更为常见，而脾脏受累在年轻患者中更为常见。年轻和老年患者的年龄校正国际预后指数评分略差（P < 0.01）。完全缓解率随年龄下降，从最年轻患者中的68%降至最年长患者中的45%（P < 0.0001）。无事件生存期和总生存期的中位数也随年龄下降（P < 0.0001）。