HIGH-GRADE NON-HODGKINS-LYMPHOMA IN THE ELDERLY - 12-YEAR EXPERIENCE IN THE GRAMPIAN REGION OF SCOTLAND

A retrospective examination of patients with high grade non-Hodgkin's lymphoma (HG NHL) presenting in the Grampian Region of Scotland from 1 980-1992 was undertaken to determine the disease characteristics and o utcome in patients over the age of 60 years at diagnosis. This group o f patients was found to account for 68 per cent of HG NHL presenting i n this region. No difference in clinical stage or histology was noted compared to their younger counterparts. The elderly had a significantl y poorer survival with an increase in lymphoma-related and unrelated d eaths. On Cox regression analysis the main survival advantage was conf erred by completion of 'radical' treatment; elderly patients who were given 'radical' therapy had a median survival of 50 months compared to median survival of 10 months in the 'non-radical' group. Patients who had a good performance status at diagnosis had also a significant sur vival advantage. Histology, clinical stage at diagnosis and age over 6 0 had no independent significant effect on survival. Not all the facto rs that resulted in 'non-radical' therapy being given are explicable b ut we conclude that 'radical' therapy is achievable in 50 per cent of patients over the age of 60 years with an effective outcome and should be pursued in the elderly when the condition of the patient allows.