Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T13:10:51.077Z Has data issue: false hasContentIssue false
  • English
  • Français

Lymphoma in older patients: clinical and therapeutic characteristics

Published online by Cambridge University Press:  05 March 2015

C Benavente ,
C Serí ,
B Iñigo  and
R Martínez
C Benavente*
Affiliation:
Department of Haematology, Hospital Clínico San Carlos, Madrid
C Serí
Affiliation:
Department of Haematology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
B Iñigo
Affiliation:
Department of Haematology, Hospital Clínico San Carlos, Madrid
R Martínez
Affiliation:
Department of Haematology, Hospital Clínico San Carlos, Madrid
*
Address for correspondence: Dra. Celina Benavente, Department of Haematology, Hospital Universitario Clínico San Carlos, Madrid, Spain. Email: celina.benavente@gmail.com
Get access Rights & Permissions [Opens in a new window]

Summary

Neoplasms of the lymphoid tissues represent a large, heterogeneous group of diseases that vary in clinical severity and response to treatment. The incidence of lymphoma in older patients is growing, yet guidelines on specifically how these patients should be treated are lacking. Moreover, older people are excluded from most of the clinical trials and management decisions are usually based on data obtained in younger patients. This review might consider the optimal strategy for lymphoma diagnosis and treatment in older patients.

Keywords

elderlyolderlymphomatreatment
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 25 , Issue 1 , February 2015 , pp. 1 - 11
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Sant, M, Allemani, C, Tereanu, Cet al. HAEMACARE Working Group. Incidence of haematologic malignancies in Europe by morphologic subtype: results of the HAEMACARE project. Blood 2010; 116: 3724–34.CrossRefGoogle Scholar
Morton, LM, Wang, SS, Devesa, SSet al. Lymphoma incidence patterns by WHO subtype in the United States, 1992–2001. Blood 2006; 107: 265–76.Google Scholar
Jemal, A, Murray, T, Samuels, A, Ghafoor, A, Ward, E, Thun, MJ. Cancer statistics, 2003. CA Cancer J Clin 2003; 53: 5–26.Google Scholar
Groves, FD, Linet, MS, Travis, LB, Devesa, SS. Cancer surveillance series: non-Hodgkin lymphoma incidence by histologic subtype in the United States from 1978 through 1995. J Natl Cancer Inst 2000; 92: 1240–51.Google Scholar
Hasselblom, S, Ridell, B, Nilsson-Ehle, H, Andersson, PO. The impact of gender, age and patient selection on prognosis and outcome in diffuse large B-cell lymphoma – a population based study. Leuk Lymphoma 2007; 48: 736–45.Google Scholar
Coiffer, B, Lepage, E, Briere, Jet al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B cell lymphoma. N Engl J Med 2002; 346: 235–42.Google Scholar
Peyrade, F, Gastaud, L, Ré, Det al. Treatment decisions for elderly patients with haematological malignancies: a dilemma. Lancet Oncol 2012; 13: 344–52.Google Scholar
Swerdlow, SH, Campo, E, Harris, NLet al. World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press, Lyon; 2008.Google Scholar
Anderson, T, Chabner, BA, Young, RCet al. Malignant lymphoma. The histology and staging of 473 patients at the National Cancer Institute. Cancer 1982; 50: 2699–707.Google Scholar
Metzgeroth, G, Schneider, S, Walz, Cet al. Fine needle aspiration and core needle biopsy in the diagnosis of lymphadenopathy of unknown aetiology. Ann Hematol 2012; 91: 1477–84.Google Scholar
Asoglu, O, Porter al, Donohue, JHet al. Laparoscopy for the definitive diagnoses of intra-abdominal lymphoma. Mayo Clin Proc 2005; 80: 625–31.CrossRefGoogle ScholarPubMed
Cheson, BD, Pfistner, B, Juweid, MEet al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25: 579–86.Google Scholar
Lister, TA, Crowther, D, Sutcliffe, SBet al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol 1989; 7: 1630–36.Google Scholar
Pfreundschuh, M, Schubert, J, Ziepert, Met al. Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B cell lymphoma: a randomised controlled trial (RICOVER-60). Lancet Oncol 2008; 9: 105–16.Google Scholar
Balducci, L. Management of cancer in the elderly. Oncology 2006; 20: 135–43.Google ScholarPubMed
Latta, S, Cygan, P, Fried, Wet al. Diffuse large B-cell non-Hodgkin lymphoma in the very elderly: challenges and solutions. Oncology 2013; 27: 126–38.Google Scholar
Nabhan, C, Smith, SM, Helenowski, Iet al. analysis of very elderly (>/=80 years) non-Hodgkin lymphoma: impact of functional status and comorbidities on outcome. Br J Haemathol 2012; 156: 196–204.Google Scholar
Merli, F, Luminari, S, Rossi, Get al. Cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab versus epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab for the initial treatment of elderly ‘fit’ patients with diffuse large B-cell lymphoma: results from the ANZINTER3 trial of the Intergruppo Italiano Linfomi. Leuk Lymphoma 2012; 53: 581–88.Google Scholar
Charlson, ME, Pompei, P, Ales, KLet al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373–83.Google Scholar
Pfreundschuh, M. How I treat elderly patients with diffuse large B-cell lymphoma. Blood 2010; 116: 5103–10.Google Scholar
Pal, SK, Katheria, V, Hurria, A. Evaluating the older patient with cancer: understanding frailty and the geriatric assessment. CA Cancer J Clin 2010; 60: 120–32.Google Scholar
Smith, A, Howell, D, Patmore, R, Jack, A, Roman, E. Incidence of haematological malignancy by sub-type: a report from the Haematological Malignancy Research Network. Br J Cancer 2011; 105: 1684–92.Google Scholar
The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med 1993; 329: 987–94.Google Scholar
Ziepert, M, Hasenclever, D, Kuhnt, Eet al. Standard International Prognostic Index remains a valid predictor of outcome for patients with aggressive CD20+ B-cell lymphoma in the rituximab era. J Clin Oncol 2010; 28: 2373–80.Google Scholar
Rosenwald, A, Wright, G, Chan, WCet al. The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma. N Engl J Med 2002; 346: 1937–47.Google Scholar
Klapper, W, Kreuz, M, Kohler, CWet al. Patient age at diagnosis is associated with the molecular characteristics of diffuse large B-cell lymphoma. Molecular Mechanisms in Malignant Lymphomas Network Project of the Deutsche Krebshilfe. Blood 2012; 119: 1882–87.CrossRefGoogle Scholar
Coiffier, B, Thieblemont, C, Van den Neste, Eet al. Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte. Blood 2010; 116: 2040–45.Google Scholar
Van der Poel, MW, Mulder, WJ, Ossenkoppele, GJet al. Comorbidity and treatment decision-making in elderly non-Hodgkin's lymphoma patients: a survey among haematologists. Neth J Med 2014; 72: 165–69.Google Scholar
Odejide, OO, Cronin, AM, Davidoff, AJ, LaCasce, AS, Abel, GA. Limited stage diffuse large B-cell lymphoma: comparative effectiveness of treatment strategies in a large cohort of elderly patients. Leuk Lymphoma 2014; 6: 1–9.Google Scholar
Peyrade, F, Jardin, F, Thiblemont, Cet al. Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: a multicentre, single-arm, phase 2 trial. Lancet Oncol 2011; 12: 460–68.Google Scholar
Weidmann, E, Neumann, A, Fauth, Fet al. Phase II study of bendamustine in combination with rituximab as first line treatment in patients 80 years or older with aggressive B-cell lymphomas. Ann Oncol 2011; 22: 1839–44.Google Scholar
Pfreundschuh, M, Trumper, L, Kloess, Met al. Two-weekly or 3-weekly CHOP chemotherapy without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2trial of the DSHNHL. Blood 2004; 104: 634–41.Google Scholar
Solal-Céligny, P, Roy, P, Colombat, Pet al. Follicular lymphoma international prognostic index. Blood 2004; 104: 1258–65.Google Scholar
Federico, M, Bellei, M, Marcheselli, Let al. Follicular lymphoma international prognostic index 2: a new prognostic index for follicular lymphoma developed by the international follicular lymphoma prognostic factor Project. J Clin Oncol 2009; 27: 4555–62.Google Scholar
Pugh, TJ, Ballonoff, A, Newman, F, Rabinovitch, R. Improved survival in patients with early stage low-grade follicular lymphoma treated with radiation: a Surveillance, Epidemiology, and End Results database analysis. Cancer 2010; 116: 3843–51.Google Scholar
Ardeshna, KM, Smith, P, Norton, Aet al. Long-term effect of a watch and wait policy versus immediate systemic treatment for asymptomatic advanced-stage non-Hodgkin lymphoma: a randomised controlled trial. Lancet 2003; 362: 516–22.Google Scholar
Rummel, MJ, Niederle, N, Maschmeyer, Get al. Bendamustine plus rituximab versus CHOP plus rituximab as first-line treatment for patients with indolent and mantle-cell lymphomas: an open-label, multicentre, randomised, phase 3 non-inferiority trial. Lancet 2013; 381: 1203–10.CrossRefGoogle ScholarPubMed
Marcus, R, Imrie, K, Solal-Celigny, Pet al. Phase III study of R-CVP compared with cyclophosphamide, vincristine, and prednisone alone in patients with previously untreated advanced follicular lymphoma. J Clin Oncol 2008; 26: 4579–86.Google Scholar
National Comprehensive Cance Network. NCCN Clinical Practice Guidelines in Oncology, version 3; 2014 (available at: http://www.nccn.org/professionals/physician_gls/f_guidelines.asp).Google Scholar
Salles, G, Seymour, JF, Offner, Fet al. Rituximab maintenance for 2 years in patients with high tumour burden follicular lymphoma responding to rituximab plus chemotherapy (PRIMA): a phase 3, randomised controlled trial. Lancet 2011; 377: 42–51.Google Scholar
Scholz, CW, Pinto, A, Linkesch, Wet al. (90)Yttrium-ibritumomab-tiuxetan as first-line treatment for follicular lymphoma: 30 months of follow-up data from an international multicenter phase II clinical trial. J Clin Oncol 2013; 31: 308–13.Google Scholar
Hoster, E, Dreyling, M, Klapper, Wet al. A next prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood 2008; 111: 558–65.Google Scholar
Martin, P, Chadbum, A, Christos, Pet al. Outcome of deferred initial therapy in mantle cell lymphoma. J Clin Oncol 2009; 27: 1209–13.Google Scholar
Kluin-Nelemans, HC, Hoster, E, Hermine, Oet al. Treatment of older patients with mantle cell lymphoma. N Engl J Med 2012; 367: 520–31.Google Scholar
Visco, C, Finotto, S, Zambello, Ret al. Combination of Rituximab, Bendamustine and Cytarabine for patients with Mantle cell non-Hodgkin lymphoma ineligible for intensive regimens or autologous transplantation. J Clin Oncol 2013; 31: 1442–49.Google Scholar
Zucca, E, Bertoni, F. Toward new treatments for mantle cell lymphoma? N Engl J Med 2013; 369: 571–72.CrossRefGoogle ScholarPubMed
Hasenclever, D, Diehl, V. A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med 1998; 339: 1506–14.Google Scholar
Moccia, AA, Donaldson, J, Chhanabhai, Met al. International prognostic score in advanced-stage Hodgkin's lymphoma: altered utility in the modern era. J Clin Oncol 2012; 30: 3383–88.Google Scholar
Björkholm, M, Svedmyr, E, Sjöberg, J. How we treat elderly patients with Hodgkin lymphoma. Curr Opin Oncol 2011; 23: 421–28.Google Scholar
Halbsguth, TV, Böll, B, Borchmann, P, Diehl, V. The unique characteristics and management of patients over 60 years of age with classic Hodgkin lymphoma. Curr Hematol Malig Rep 2011; 6: 164–71.Google Scholar
Martin, WG, Ristow, KM, Habermann, TM, Colgan, JP, Witzig, TE, Ansell, SM. Bleomycin pulmonary toxicity has a negative impact on the outcome of patients with Hodgkin's lymphoma. J Clin Oncol 2005; 23: 7614–20.Google Scholar
Böll, B, Bredenfeld, H, Görgen, Het al. A. Phase 2 study of PVAG (prednisone, vinblastine, doxorubicin, gemcitabine) in elderly patients with early unfavorable or advanced stage Hodgkin lymphoma. Blood 2011; 118: 6292–98.Google Scholar
Proctor, SJ, Wilkinson, J, Jones, Get al. Evaluation of treatment outcome in 175 patients with Hodgkin lymphoma aged 60 years or over: the SHIELD study. Blood 2012; 119: 6005–15.Google Scholar
Ansell, SM. Hodgkin lymphoma: 2012 update on diagnosis, risk-stratification, and management. Am J Hematol 2012; 87: 1096–103.Google Scholar
Younes, A, Gopal, AK, Smith, SEet al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin's lymphoma. J Clin Oncol 2012; 30: 2183–89.Google Scholar
Younes, A, Bartlett, NL, Leonard, JPet al. Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas. N Engl J Med 2010; 363: 1812–21.Google Scholar