gms | German Medical Science

The incidence of malignant lymphomas is increasing overproportionate especially in Europe, North America, and in elderly patients. Two third of the patients suffering from lymphoma are older than 65 years when disease is first diagnosed. In many guidelines age over 65 or 70 years or typical comorbidity of elderly patients is a risk factor for chemotherapy.

We report on geriatric lymphoma patients who were treated in a single center during 2003 to 2005. A total of 23 patients suffering from malignant lymphoma were treated in our hospital during the past 2 years.

Patient characteristics

Male: 8; female: 15

Age: 68-96 years, median: 81 years

Tumour characteristics

Malignancy grade: low grade: 5; intermediate: 4; high grade: 15

Newly diagnosed: 21/23 patients; relapse: 2/23 patients

1 malignant lymphoma was diagnosed as second malignancy; primary tumour: colorectal cancer

1 malignant lymphoma only affected the central nervous system

Therapy and follow up: Initially detailed geriatric assessment (general state of health, Barthel index, Charleston index, social activity) was performed prior to therapy as well as usual staging. After that a team defined the therapeutic strategy appropriate to the patient and according to the risk factors.

According to malignancy grade, spreading of lymphoma, and assessment different kinds of therapy were performed--intravenous treatment, oral chemotherapy or radiation (CHOP +/- Rituximab, R-B, COP, Ixoten). Two patients did not receive specific anti-cancer therapy but “best supportive care”. 13% of patients were enrolled in clinical studies. 14/23 patients are still alive, 8/23 patients are under active therapy at present, 6/23 patients are ongoing in complete remission (CR).

Summary: In view of the general circumstances and the geriatric assessment the anti-tumour therapy of geriatric patients suffering from malignant lymphoma is strongly indicated and promising.