PROGNOSTIC IMPORTANCE OF ADVANCED AGE IN AGGRESSIVE NON-HODGKINS MALIGNANT-LYMPHOMA

The importance of age as a prognostic factor in aggressive non-Hodgkin 's malignant lymphoma (NHL) remains controversial. It is not clear whe ther age is an independent factor, reflecting the limited physiologic reserves of the patient, and leading in any treatment conditions to th e poorer treatment outcome. This study was aimed at assessing the infl uence of age on treatment results in NHL patients. Therefore, the reco rds of 40 patients with histologically confirmed NHL of intermediate a nd high-grade malignancy, according to the Working Formulation, who we re treated by Adriamycin-containing chemotherapy, were retrospectively reviewed. There were 25 patients above 60 years of age and 15 patient s below this age. Myelotoxicity was observed in 60% of the patients in the younger and in 48% patients in the older age group. The median ti me to dose-limiting toxicity, average percentage of projected dose int ensity for all drugs, and percentage of projected dose intensity did n ot differ significantly in the two groups. Complete remissions (CR) we re obtained in 67 and 64% of the younger and older groups, respectivel y. Progressive disease was observed during the treatment in 20% of the patients in each age group. Median survival was 36.5 and 32 months in the younger and older group, respectively. In conclusion, age alone i s not an absolute predictor of survival of treated elderly patients wi th aggressive NHL. Dose rate, tolerance of treatment and achievement o f CR are additional important prognostic factors. Dose intensity shoul d not be automatically reduced at the beginning of the treatment, espe cially now that growth factors are available.