The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma

Julie Marie Vose, James Olen Armitage, D. D. Weisenburger, Philip Jay Bierman, S. Sorensen, M. Hutchins, D. F. Moravec, D. Howe, M. D. Dowling, J. Mailliard, P. S. Johnson, W. Pevnick, W. M. Packard, J. Okerbloom, R. F. Thompson, R. M. Langdon, G. Soori, C. Peterson

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Abstract

Non-Hodgkin's lymphoma (NHL) is a malignancy that occurs frequently in the elderly with a median age >60 years. However, most chemotherapy trials have included predominantly patients < 60 years of age. We treated 157 patients with diffuse aggressive NHL between September 1982 and May 1986 with cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), procarbazine, bleomycin, vincristine, and prednisone (CAP/BOP). There were no treatment exclusions for age. Patients in this study ranged in age from 15 to 91 years (median, 63) with 112 patients ≥ 60 years of age. The overall complete remission (CR) rate was 65% with no significant difference for age < 60 (76%) v age ≥ 60 (61%) (P = .18). With a median 36-month follow-up (range, 22 to 65 months), the overall 5-year survival was 42%. The patients < 60 years old had a 62% 5-year survival in contrast to a 34% 5-year survival in those patients ≥ age 60 (P = .01). The deaths attributed to tumor or treatment-related toxicity were similar above and below age 60. The difference in survival was due to other causes of death not obviously related to the lymphoma or its therapy - occurring in 22% of patients ≥ 60 years of age but only 2% of patients < 60 years (P = .005). Our data supports the position that aggressive NHL in elderly patients is not significantly less responsive than in younger patients; however, the inclusion of older patients in clinical trials will decrease the overall survival secondary to deaths due to apparently unrelated causes.

Original languageEnglish (US)
Pages (from-to)1838-1844
Number of pages7
JournalJournal of Clinical Oncology
Volume6
Issue number12
DOIs
StatePublished - Jan 1 1988

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Non-Hodgkin's Lymphoma
Drug Therapy
Survival
Doxorubicin
Procarbazine
Bleomycin
Vincristine
Prednisone
Cyclophosphamide
Cause of Death
Lymphoma
Neoplasms
Therapeutics
Clinical Trials

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma. / Vose, Julie Marie; Armitage, James Olen; Weisenburger, D. D.; Bierman, Philip Jay; Sorensen, S.; Hutchins, M.; Moravec, D. F.; Howe, D.; Dowling, M. D.; Mailliard, J.; Johnson, P. S.; Pevnick, W.; Packard, W. M.; Okerbloom, J.; Thompson, R. F.; Langdon, R. M.; Soori, G.; Peterson, C.

In: Journal of Clinical Oncology, Vol. 6, No. 12, 01.01.1988, p. 1838-1844.

Research output: Contribution to journalArticle

Vose, JM, Armitage, JO, Weisenburger, DD, Bierman, PJ, Sorensen, S, Hutchins, M, Moravec, DF, Howe, D, Dowling, MD, Mailliard, J, Johnson, PS, Pevnick, W, Packard, WM, Okerbloom, J, Thompson, RF, Langdon, RM, Soori, G & Peterson, C 1988, 'The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma', Journal of Clinical Oncology, vol. 6, no. 12, pp. 1838-1844. https://doi.org/10.1200/JCO.1988.6.12.1838
Vose, Julie Marie ; Armitage, James Olen ; Weisenburger, D. D. ; Bierman, Philip Jay ; Sorensen, S. ; Hutchins, M. ; Moravec, D. F. ; Howe, D. ; Dowling, M. D. ; Mailliard, J. ; Johnson, P. S. ; Pevnick, W. ; Packard, W. M. ; Okerbloom, J. ; Thompson, R. F. ; Langdon, R. M. ; Soori, G. ; Peterson, C. / The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma. In: Journal of Clinical Oncology. 1988 ; Vol. 6, No. 12. pp. 1838-1844.
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abstract = "Non-Hodgkin's lymphoma (NHL) is a malignancy that occurs frequently in the elderly with a median age >60 years. However, most chemotherapy trials have included predominantly patients < 60 years of age. We treated 157 patients with diffuse aggressive NHL between September 1982 and May 1986 with cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), procarbazine, bleomycin, vincristine, and prednisone (CAP/BOP). There were no treatment exclusions for age. Patients in this study ranged in age from 15 to 91 years (median, 63) with 112 patients ≥ 60 years of age. The overall complete remission (CR) rate was 65{\%} with no significant difference for age < 60 (76{\%}) v age ≥ 60 (61{\%}) (P = .18). With a median 36-month follow-up (range, 22 to 65 months), the overall 5-year survival was 42{\%}. The patients < 60 years old had a 62{\%} 5-year survival in contrast to a 34{\%} 5-year survival in those patients ≥ age 60 (P = .01). The deaths attributed to tumor or treatment-related toxicity were similar above and below age 60. The difference in survival was due to other causes of death not obviously related to the lymphoma or its therapy - occurring in 22{\%} of patients ≥ 60 years of age but only 2{\%} of patients < 60 years (P = .005). Our data supports the position that aggressive NHL in elderly patients is not significantly less responsive than in younger patients; however, the inclusion of older patients in clinical trials will decrease the overall survival secondary to deaths due to apparently unrelated causes.",
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AU - Sorensen, S.

AU - Hutchins, M.

AU - Moravec, D. F.

AU - Howe, D.

AU - Dowling, M. D.

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AU - Johnson, P. S.

AU - Pevnick, W.

AU - Packard, W. M.

AU - Okerbloom, J.

AU - Thompson, R. F.

AU - Langdon, R. M.

AU - Soori, G.

AU - Peterson, C.

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N2 - Non-Hodgkin's lymphoma (NHL) is a malignancy that occurs frequently in the elderly with a median age >60 years. However, most chemotherapy trials have included predominantly patients < 60 years of age. We treated 157 patients with diffuse aggressive NHL between September 1982 and May 1986 with cyclophosphamide, Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH), procarbazine, bleomycin, vincristine, and prednisone (CAP/BOP). There were no treatment exclusions for age. Patients in this study ranged in age from 15 to 91 years (median, 63) with 112 patients ≥ 60 years of age. The overall complete remission (CR) rate was 65% with no significant difference for age < 60 (76%) v age ≥ 60 (61%) (P = .18). With a median 36-month follow-up (range, 22 to 65 months), the overall 5-year survival was 42%. The patients < 60 years old had a 62% 5-year survival in contrast to a 34% 5-year survival in those patients ≥ age 60 (P = .01). The deaths attributed to tumor or treatment-related toxicity were similar above and below age 60. The difference in survival was due to other causes of death not obviously related to the lymphoma or its therapy - occurring in 22% of patients ≥ 60 years of age but only 2% of patients < 60 years (P = .005). Our data supports the position that aggressive NHL in elderly patients is not significantly less responsive than in younger patients; however, the inclusion of older patients in clinical trials will decrease the overall survival secondary to deaths due to apparently unrelated causes.

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