EFFECT OF AGE ON THE CHARACTERISTICS AND CLINICAL BEHAVIOR OF NON-HODGKINS-LYMPHOMA PATIENTS

Background: The goals of this study are to describe the frequency, cli nical characteristics, and outcome of the different non-Hodgkin's lymp homas according to age. Patients and methods. Patients included in the recently published analysis of the Non-Hodgkin's Lymphoma Classificat ion Project were analyzed. All patients had their slides reviewed and classified by five independent expert hematopathologists. Lymphomas we re classified according to the Revised European-American Classificatio n 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 greater than or equal to 70 years. Results. Few diffe rences were observed between the age groups with regard to lymphoma ty pes and clinical characteristics. Anaplastic large cell lymphoma, Burk itt's lymphoma, and lymphoblastic lymphoma were observed more frequent ly in patients younger than 35 years, whereas small lymphocytic and ly mphoplasmacytoid lymphomas were observed more frequently in patients o lder than 70 years. Mantle cell lymphoma and marginal zone lymphomas w ere observed more frequently in middle-aged patients. Poor performance status was more frequent in older patients, as was bone marrow infilt ration, whereas spleen involvement was more frequent in younger patien ts. Young and older patients had a slightly worse age-adjusted Interna tional Prognostic Index score (P < 0.01). Complete response rates decr eased 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 h ave a poorer outcome than younger patients but age alone is not suffic ient to discriminate patients with a poor outcome. However, the histol ogic type of lymphoma and clinical characteristics may define a subgro up of patients with a poor outcome in each age category.