Non-Hodgkin's Lymphoma in the Elderly

BACKGROUND: The incidence of non-Hodgkin's lymphoma in the elderly continues to increase. There has been a tendency among some treating physicians to minimize appropriate workup and treatment, which may product a negative effect on outcomes. METHODS: Several characteristics of non-Hodgkin's lymphoma in the elderly are reviewed, including classification and staging, pathophysiology, clinical presentation, and treatment strategies. RESULTS: The Working Formulation remains the principal classification used. In order and younger individuals, the prevalence of histologic subtypes and the stage at presentation are similar. Regardless of the regimen chosen, doxorubicin or mitoxantrone should be included if optimal responses are to be obtained. New purine analogs extend the therapeutic armamentarium. CONCLUSIONS: Advanced age and comorbidities can impair the capability for treatments to control non-Hodgkin's lymphoma. To enhance results, more studies that focus on the elderly are needed on drug combinations and the new purine analogs.