Non-Hodgkin’s lymphoma in the elderly. Age is not always an adverse prognostic factor

A retrospective study analyzing non-Hodgkin's lym-phoma (NHL) diagnosed in patients in our center above 65 years of age between the years 1977–1991 is reported. Histological classification has been completed following the criteria of the Working Formulation. Of 521 patients, 427 were candidates for evaluation. Those above 65 years of age comprised the subject of our study, with a total of 95 cases. Population: 43/52 male/female, 47 intermediate-grade NHL, 38 low-grade NHL, Ann Arbor stages I–II/III–IV 36/59, performance status (PS) 0-1/2-3 39/56, B symptoms yes/no 47/48, lactic dehydrogenase (LDH) normal/high 33/62, albumin normal/low 75/20, Cu normal/high 44/37 (the rest not available), B2 microglobuline normal/high 17/11 (the rest not available), tumor burden (MD Anderson) high/intermediate/low 41/28/26. The median range of cause specific survival was 30 months (50 for the low-grade NHL, 17 for the intermediate-grade). Significant prognostic factors: Histological grade (low versus high and intermediate), PS 0/1 versus 2/3, presence versus absence of B symptoms, normal versus high LDH, tumor burden (low versus high and intermediate). There is no significant statistical difference between elderly patients and young patients with a poor PS, phases I and IV, low albumin level and high and low tumor burden. Age as an adverse prognostic factor is evident in patients with a strong PS, phases II and III, normal albumin and intermediate tumor burden. The characteristics and prognostic factors of elderly patients with NHL are similar to those of the young. Age does not always function as an independent prognostic factor; age has no effect on groups with favorable or unfavorable prognostic factors and it is in the intermediate prognostic groups in which age plays a part in survival.