AGGRESSIVE CHEMOTHERAPY FOR DIFFUSE HISTIOCYTIC LYMPHOMA IN THE ELDERLY - INCREASED COMPLICATIONS WITH ADVANCING AGE
AGGRESSIVE CHEMOTHERAPY FOR DIFFUSE HISTIOCYTIC LYMPHOMA IN THE ELDERLY - INCREASED COMPLICATIONS WITH ADVANCING AGE
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DOI：
10.1111/j.1532-5415.1984.tb02020.x
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发表时间：
1984-01-01
影响因子：
6.3
通讯作者：
POTTER, JF
中科院分区：
文献类型：
--
作者：
ARMITAGE, JO;POTTER, JF
20名患者≥岁的患者被纳入一项使用环磷酰胺、阿霉素、长春新碱和泼尼松治疗弥漫性组织细胞淋巴瘤的研究。这些患者的年龄范围为70-94岁（中位数75岁）。在治疗试验中还有55名年轻患者（年龄范围33-69岁）。未根据年龄进行剂量调整。老年患者的完全缓解率（45%）与年轻患者（53%）无差异。老年患者的总生存期（中位数13个月）平均22 mo.对于年龄56-69岁和41个月的患者。对于33-55岁的患者），但没有显著差异。在前2个治疗周期内，25%的患者死于淋巴瘤以外的原因。70岁的患者与2%的年轻患者相比（P < 0.01）。此外，另外3名年龄分别为79岁、65岁和59岁的患者在第4或第5个治疗周期死于淋巴瘤以外的原因。因此，30%的患者≥70岁以上患者死于非淋巴瘤原因，而年轻患者为5%（P < 0.01）。老年患者耐受治疗的能力改变是否反映了骨髓功能下降、药物代谢改变、衰老的其他影响或这些因素的组合尚不清楚。在治疗老年患者时，改变药物剂量可能是适当的;特别注意支持性措施似乎是适当的。
Twenty patients .gtoreq. yr of age were included in a study of the treatment of diffuse histiocytic lymphoma utilizing cyclophosphamide, adriamycin, vincristine and prednisone. These patients ranged in age from 70-94 yr (median 75 yr). There were also 55 younger patients (age range 33-69 yr) in the treatment trial. There were no dose adjustments for age. The complete remission rate in the elderly patients (45%) was not different from that in the younger patients (53%). The overall survival in the elderly patients (median 13 mo.) was somehwat shorter than that in the younger patients (medians 22 mo. for patients 56-69 yr of age and 41 mo. for patients 33-55 yr of age), but not significantly different. Death during the first 2 treatment cycles from causes other than lymphoma occurred in 25% of the patients .gtoreq. 70 yr of age vs. 2% of younger patients (P < 0.01). In addition, 3 other patients aged 79, 65 and 59 yr died in the 4th or 5th cycles of treatment from causes other than lymphoma. Thus, 30% of patients .gtoreq. 70 yr of age died during therapy from causes other than lymphoma, vs. 5% of younger patients (P < 0.01). Whether this altered ability to tolerate therapy in the older patients reflected decreased marrow function, altered drug metabolism, other effects of aging or a combination of these factors is not clear. It might be appropriate to alter drug doses when treating elderly patients; particular attention to supportive measures seems appropriate.