[Long-term results in 172 highly malignant non-Hodgkin's lymphomas with special reference to older patients]

In 172 patients of the years 1976-1984 with a median age of 61 (16-89 years) the probability of survival was 55% after nine years. The seventh to ninth decade of life (n = 88) did not differ significantly in terms of the survival prognosis (47%) from the younger age groups (n = 84) with 59%. Immunoblastic (n = 72), centroblastic (n = 65) and unclassifiable (n = 35) lymphomas were prognostically similar and could hence be evaluated together. Stages I A (n = 58) with 83% and IV B (n = 15) with 20% differed from all others (n = 99), for which a survival rate of 41% was calculated. With the CHOP scheme (n = 76), a complete remission could be induced in 70% of the stages II A/B, III A/B and IV A (n = 54) and in 95% of stage I A (n = 19). In stage IV B (n = 14), more intensive schemata were not successful, only inducing two remissions. After sequential combination of polychemotherapy and large-field radiotherapy, the relapse-free survival was higher than after radiation or cytostatics alone. This was shown most distinctly in stage I A, in which a value of 82% compared to only 29% after radiotherapy was found for the combined method. Since this was not associated with higher rates of complications so far even with the older patients, we regard this procedure as major advance in the therapy of prognostically unfavorable lymphomas.