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KMID : 0360320010330040324
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Journal of Korean Cancer Research Association
2001 Volume.33 No. 4 p.324 ~ p.328
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Clinical Prognostic Factors and Treatment Outcome of Aggressive Non - Hodgkin`s Lymphoma in Elderly Patients
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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
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Abstract
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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.
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KEYWORD
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Malignant lymphoma, Prognostic factors, Aggressive lymphoma, Old age,
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