Clinical Prognostic Factors and Treatment Outcome of Aggressive Non - Hodgkin`s Lymphoma in Elderly Patients
대한암학회지 2001년 33권 4호 p.324 ~ 328
소속 상세정보
최정혜/Jung Hye Choi
안명주/기모란/오호석/이영열/최일영/김인순/Myung Ju Ahn/Mo Ran Ki*/Ho Suk Oh/Ho Suk Oh/Young Yuel Lee/Il Young Choi/In Soon Kim
KMID : 0360320010330040324
Abstract
PURPOSE:
The aim of this study was to determine the prognostic factors and treatment outcome of for elderly patients (age>or=60 at time of diagnosis) with aggressive non-Hodgkin's lymphoma (NHL).
MATERIALS AND METHODS:
We analyzed 52 patients diagnosed with aggressive NHL between January 1990 and May 2000.
RESULTS:
The patient's median age was 69 years (range: 60~92). Thirty-two (61.5%) patients were male. Patients included those with diffuse large B cell (53.8%), peripheral T cell (23.1%), AILD-like T-cell (3.8%), angiocentric (3.8%), mantle cell (3.8%), Burkitt's lymphoma (3.8%), and others (7.9%). International prognostic index (IPI) parameters were as follows: elevated LDH (60.8%), ECOG performance status>or=2 (32.7%), advanced stage (III/IV, 62.7%), and extranodal site>or=2 (11.5%). Twenty-six (50.0%) patients demonstrated a high and high-intermediate IPI. The median follow-up for surviving patients was 26.6 months. The overall median survival was 22.7 months and the 2-year survival rate was 46.9%. Among the 49 patientstreated with chemotherapy, 28 (57.1%) patients achieved complete remission (CR). Univariate analysis identified 8 prognostic factors for overall survival: age<70 (P=0.04), low/low-intermediate IPI (P=0.02), good performance (P= 0.04), normal WBC (P=0.008), normal Hb (P=0.02), normal LDH (P=0.04), CR on first line therapy (P<0.001), and absence of B symptom (P=0.001). In the multivariate analysis, the independent prognostic factors for improved overall survival were age <70 (P=0.03), low/low-intermediate IPI (P=0.03), normal WBC (P=0.006), and CR on first line therapy (P<0.001).
CONCLUSION:
In our experience, even elderly patients (>or=60 years) with aggressive NHL can be successfully treated with conventional chemotherapy and the important prognostic factors for survival are age, IPI, initial WBC, and CR on first line treatment.
키워드
Malignant lymphoma; Prognostic factors; Aggressive lymphoma; Old age;
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