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Aggressive lymphoma in the elderly.

S M Lichtman1

  • 1Department of Medicine, North Shore University Hospital-New York University School of Medicine, Manhasset 11030, USA. lichtman@nshs.edu

Critical Reviews in Oncology/Hematology
|March 29, 2000
PubMed
Summary
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Older adults with non-Hodgkin

Area of Science:

  • Geriatric Oncology
  • Hematology
  • Clinical Trials

Background:

  • The aging US population necessitates understanding non-Hodgkin's lymphoma (NHL) treatment in older adults.
  • Age is a known adverse prognostic factor in NHL.
  • Comorbidities complicate treatment and survival assessment in elderly patients.

Purpose of the Study:

  • To review current treatment strategies for aggressive non-Hodgkin's lymphoma in elderly patients.
  • To highlight challenges and future research directions in geriatric NHL management.

Main Methods:

  • Review of randomized clinical trials focusing on elderly patients with aggressive non-Hodgkin's lymphoma.
  • Analysis of treatment regimens, including cyclophosphamide, Adriamycin, vincristine, prednisone (CHOP).

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Main Results:

  • Randomized trials reaffirm CHOP as standard, emphasizing adequate dosing, scheduling, and anthracyclines.
  • Older patients with significant comorbidity and poor performance status may benefit from alternative regimens.
  • Selected fit older patients with relapsed disease may respond to reinduction or bone marrow transplantation.

Conclusions:

  • Optimizing CHOP therapy (dosing, schedule, anthracyclines) is crucial for elderly NHL patients.
  • Further research is needed to define the role of comorbidity, organ dysfunction, and geriatric assessments in treatment decisions.
  • Exploration of novel therapeutic agents for this population is warranted.