| Objective:To explore the clinical features,pathological types,treatment and prognosis related factors of elderly lymphoma.Methods:To retrospectively analyze the clinical data of 287 elderly patients with lymphoma(aged 65 and over)who were newly diagnosed at the Department of Hematology of the Cancer Center of Jilin University First Hospital from January 2008 to December 2016,including clinical features and pathological types.,treatment and prognosis related factors.The elderly lymphoma patients in this group were followed up until December 2017.Kaplan-Meier method was used for survival analysis,Log-rank test was used for single factor analysis,and multi-factor analysis was performed by COX proportional hazard model.Results:1.Older age lymphoma,male than female,male/female 1.49:1,median age 72(65-90).2.Of the 287 elderly lymphomas,257 were non-Hodgkin’s lymphomas,accounting for 89.54%;12 were Hodgkin’s lymphomas,accounting for 4.18%;the remaining 18 were lymphomas of unknown pathological type.Of the 257 non-Hodgkin’s lymphomas,207 were pathologic phenotypes,accounting for 72.13%,and 35 were pathological phenotypes,accounting for 12.20%.The main pathological type is diffuse large B-cell lymphoma,134 cases,accounting for 46.70%,followed by follicular lymphoma,18 cases,accounting for 6.27%.3.Treatment options include: Hodgkin’s lymphoma: ABVD-based chemotherapy;Non-Hodgkin’s lymphoma: 1)CHOP or CHOP-like chemotherapy 2)Rituximab in combination with CHOP or CHOP-like chemotherapy 3)Combined with other targeted therapies And other treatments(including bortezomib,cell biotherapy,and radiotherapy).4.There were 162 elderly patients with lymphoma who received ≥4 cycles of treatment.The average age was 71.91 years(65-87 years),male/female was 1.49:1.According to the Ann-Arbor stage,107 patients were in stage III-IV.Accounting for 66.05%.The overall response rate of ORR was 83.95%,CR+CRu was 28.84%(37/162),PR was 61.11%(99/162),PD was 8.02%(13/162),and SD was 8.02%(13/162).5.Patients who received ≥4 courses of regular treatment were followed up.By December 2017,89 patients survived,and the survival rate was 56.32%.The median survival time was 51 months.The one-,two-,and three-year survival rates were 79.75%,48.73%,and 30.38%,respectively.6.Univariate prognostic analysis showed that gender,B symptoms,underlying disease,IPI score,β2 microglobulin,pathological types and other factors may be related to the prognosis of elderly patients with lymphoma;multivariate analysis showed that IPI score,B symptoms,β2 microglobulin There is a statistically significant difference from the prognosis,but the three are also prognostic factors for non-elderly lymphomas.Considering it is not an independent prognostic factor for elderly lymphomas.Conclusions:1.Older lymphomas,more men than women,were more likely to have B symptoms(66.55%)at the time of initial diagnosis,advanced disease(64.81% in stage III/IV),and about ≥50% of patients had erythrocyte sedimentation,lactate dehydrogenase,and β2 microglobulin.Increased,more than 50% combined with underlying diseases.2.Non-Hodgkin’s lymphoma is the main type of elderly lymphoma.The most common pathological type is diffuse large B-cell lymphoma,followed by follicular lymphoma.Pathological features are not unique.3.Aged lymphoma had a better survival time than patients with non-standardized therapy when given regular treatment ≥4 courses,and the median survival of patients with B-cell lymphoma was better than that of T-cell lymphoma.There was significant difference between them(P=0.034).4,The underlying disease may not be a prognostic indicator of the median survival time of elderly lymphomas.Patients with advanced lymphoma,after completing regular treatment(≥ 4 courses of treatment),may improve the prognosis of elderly patients. |
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