Multicentric prospective Study of Differential Treatment for Elderly Patients Affected by Aggressive Non Hodgkin Lymphoma Based On a Geriatric Multidimensional Analysis.

Abstract 4775

From November 2002 to March 2006 in the centres of the region Marche participating in the study have been diagnosed 91 new cases of lymphoma B diffuse large cells in patients aged 65 years or more.

All the 91 patients enrolled prospectively in our study were assessed on the basis of multidimensional geriatric evaluation (MGE).

MGE analysed in detail the following aspects of elderly: Functional status, Socio-economic conditions, State cognitive, State emotional, Therapy pharmacology, State nutritional and every geriatric syndromes.

On the basis of MGE we have identified 3 groups. The first group was composed of the patients who had no disability and that they could receive a standard chemotherapy with CHOP-Rituximab scheme.

The second group of patients had at most 2 co-morbidities of moderate grade in the absence of geriatric syndromes. These patients have received a therapy chop-like with anthracycline liposomal peghilated (Caelyx).

The third group composed of “frail patients” showed over the 85 years, 3 or more co-morbidities ADL <6 and one or more geriatric syndromes. These patients run therapy with chop scheme with reducing dose of 50%.

54 patients (59%) were allocated to the first group, 22 (25%) in the second and 15 (16%) in the third. In the first group, after the treatment, 82% has obtained the complete remission, and in the second and third group is obtained respectively in 64% and 60%. It was observed 1 death toxic to the first and third group and 2 in the second. Currently with a median follow-up of 55 months are live in complete remission 31 patients (57%) of the group 1, 7 patients (32%) of the group 2 and 3 patients (20%) of the group 3. The MGE has proven a useful instrument for an objective evaluation of elderly patients and has been possible to guide to the choice of therapy more appropriate also in patients that showed relevant co-morbidities.