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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Primary Lymphoid Organs01:16

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Primary lymphoid organs are pivotal in the formation, development, and maturation of lymphocytes, the white blood cells that serve as the backbone of our immune system. This crucial function underscores their fundamental role in maintaining our overall health and immunity. The two primary lymphoid organs of prime importance are the red bone marrow and the thymus.
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Enhancing Tumor Content through Tumor Macrodissection
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Diffuse large B-cell lymphoma in elderly patients: a retrospective analysis.

S Diem1, S Ess2, Th Cerny1

  • 1Department of Oncology and Hematology, Cantonal Hospital St. Gallen, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.

European Journal of Internal Medicine
|June 2, 2014
PubMed
Summary

Elderly patients with diffuse large B-cell lymphoma (DLBCL) receiving standard R-CHOP/CHOP treatment showed better survival. Alternative regimens were linked to poorer outcomes, suggesting R-CHOP should be considered for older DLBCL patients.

Keywords:
DLBCLElderlyR-CHOP

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Area of Science:

  • Oncology
  • Hematology
  • Clinical Research

Background:

  • Limited data exists on the care and outcomes for elderly patients diagnosed with diffuse large B-cell lymphoma (DLBCL) outside of clinical trials.
  • This study addresses the need for real-world evidence in this demographic.

Purpose of the Study:

  • To analyze patterns of care and survival outcomes for elderly patients with DLBCL.
  • To compare treatment strategies and their impact on overall survival (OS) across different age groups.

Main Methods:

  • Retrospective analysis of 128 DLBCL patients aged over 60 years from 2000-2010.
  • Data collected from a regional cancer registry and chart reviews.
  • Patients categorized into three age groups: 60-69, 70-79, and 80+ years.

Main Results:

  • Patients receiving 6 cycles of R-CHOP/CHOP demonstrated significantly better median overall survival (OS) compared to those on other regimens across all age groups.
  • Median OS for R-CHOP/CHOP was 54, 31, and 24 months for the 60-69, 70-79, and 80+ age groups, respectively.
  • Multivariable analysis indicated that regimens other than 6 cycles of R-CHOP/CHOP were significantly associated with poor survival, with a 6% increased mortality risk per year of age from 60 onwards.

Conclusions:

  • Treatment regimens deviating from 6 cycles of R-CHOP/CHOP are significant predictors of survival in elderly DLBCL patients within this network.
  • The R-CHOP treatment regimen warrants serious consideration for elderly patients diagnosed with DLBCL due to improved survival outcomes.