Significance of Clinical Factors As Prognostic Indicators for Mature T-Cell Non-Hodgkin Lymphoma Patients: A Retrospective Analysis of Chinese Cases

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5093-5093
Author(s):  
Wanzhuo Xie ◽  
Keyue Hu ◽  
Fan Xu ◽  
De Zhou ◽  
Weijia Huang ◽  
...  
Keyword(s):  
T Cell ◽  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Bone Marrow Involvement ◽  
International Prognostic Index ◽  
Eastern Cooperative Oncology Group ◽  
Intensive Chemotherapy ◽  
Clinical Factors ◽  
Non Hodgkin Lymphoma ◽  
Ann Arbor

Abstract Abstract 5093 Objectives: To retrospectively analyze the significance of different clinical factors for predicting the prognosis of mature T-cell non-Hodgkin lymphoma (MTCL) patients. Methods: Two hundred and fifty-two MTCL patients admitted from 2005 to 2011 into the First Affiliated Hospital of the Zhejiang University were retrospectively reviewed. All diagnoses were confirmed by histopathological hematoxylin and eosin (HE) staining and prognostic values of β2-microglobulin (β2-MG) levels, lactate dehydrogenase (LDH) levels, B symptoms, Ann Arbor stages, international prognostic index (IPI), Eastern Cooperative Oncology Group (ECOG) performance status, bone marrow involvement (BMI) and extra nodal involvement (ENI) for the overall survival (OS) were evaluated. Additionally, we compared the OS of patients treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and patients treated with an alternative intensive chemotherapy. Results: At a median follow-up of 23 months, the OS rate was 23. 8%. Our results revealed that the presence of B symptoms (P <0. 001), ECOG score≥2 (P <0. 001), BMI (P <0. 001), elevated LDH levels (P <0. 001), elevated β2-MG levels (P<0. 001), Ann Arbor stages III/IV (P=0. 007) and IPI ≥3 (P=0. 001) were factors for a poor OS prognosis and intensive chemotherapy showed a better OS outcome than CHOP treatment. Conclusion: Elevated LDH and β2-MG levels, B symptoms, Ann Arbor stage III/IV, BMI, high IPI indexes and ECOG scores predict an unfavorable prognosis of MTCL patients. When compared with the classical CHOP regimen, the intensive chemotherapy treatment can improve the prognosis of patients with MTCL. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Phase 2 trial of infusional cyclophosphamide, doxorubicin, and etoposide in patients with poor-prognosis, intermediate-grade non-Hodgkin lymphoma: an Eastern Cooperative Oncology Group trial (E3493)

Blood ◽  
2002 ◽  
Vol 100 (5) ◽  
pp. 1634-1640 ◽  
Author(s):  
Joseph A. Sparano ◽  
Edie Weller ◽  
Tipu Nazeer ◽  
Thomas Habermann ◽  
Ann E. Traynor ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
International Prognostic Index ◽  
Eastern Cooperative Oncology Group ◽  
Prognostic Index ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Intermediate Grade ◽  
Non Hodgkin Lymphoma

Preclinical and clinical evidence suggest a potential advantage for infusional therapy in lymphoma. Sixty-two analyzable patients with predominantly intermediate-grade non-Hodgkin lymphoma received cyclophosphamide (200 mg/m2 per day), doxorubicin (12.5 mg/m2 per day), and etoposide (60 mg/m2per day) (CDE) by continuous intravenous infusion for 4 days (96 hours) every 3 weeks for a maximum of 8 cycles. By the age-adjusted International Prognostic Index (IPI), 42% were at high risk and 58% were at high-intermediate risk. Complete response (CR) occurred in 30 (48%) patients (95% confidence interval [CI], 35%, 64%), and partial response occurred in 16 (26%) patients, yielding an overall response rate of 74% (95% CI, 62%, 84%). Failure-free survival (FFS) rates at 1 and 2 years were 55% (95% CI, 43%, 67%) and 50% (95% CI, 38%, 62%), respectively. When comparing the outcome for 62 patients receiving infusional CDE with historical data derived from 927 IPI-matched lymphoma patients using a Cox proportional hazards model, there was a nonsignificant trend favoring CDE in FFS (P = .12) and overall survival (P = .09). Severe or life-threatening toxicity included neutropenia (68%), anemia (57%), thrombocytopenia (44%), and infection (24%). Two patients (3%) died of treatment-related infectious complications. The primary end point of improving 1-year FFS from 55% to 70% was not achieved with infusional CDE given as initial therapy in patients with poor-risk intermediate-grade lymphoma. It is unlikely that infusional therapy as used in this study produces a 25% or greater relative improvement in FFS compared with standard therapy.

Association of Hodgkin Lymphoma and Non-Hodgkin Lymphoma In the Same Patient. Clinicopathologic Characteristics and Outcome In a Series of 20 Cases

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 3886-3886
Author(s):  
Stefano Fogazzi ◽  
Alessandra Tucci ◽  
Chiara Bottelli ◽  
Marco Ungari ◽  
Fabio Facchetti ◽  
...  
Keyword(s):  
T Cell ◽  
Hodgkin Lymphoma ◽  
Response Rate ◽  
Conflicts Of Interest ◽  
Stage Iii ◽  
Classical Type ◽  
Composite Lymphoma ◽  
Histologic Subtype ◽  
Non Hodgkin Lymphoma ◽  
Systemic Symptoms

Abstract Abstract 3886 The possibility that a non-Hodgkin lymphoma (NHL) is diagnosed either simultaneously or at a different time in patients with Hodgkin lymphoma (HL) has been reported both as single case reports and in small series. However the significance of such an association is still unclear. We searched the database of HL consecutively diagnosed at our Institution in order to identify such cases and to detect any specific clinicopathological or prognostic characteristics. Twenty cases were retrieved representing to our knowledge the largest series reported so far. Fifteen of them were diagnosed over the last ten years and represented 4,6% of the 326 cases of HL diagnosed during the same time period. There were 12 males and 8 females. Median age was 58. It was lower in patients developing HL as the first lymphoma (35 vs 65). HL was diagnosed first in 7 cases and as the second lymphoma in 9 cases. The mean interval between the two diagnoses was longer when HL occurred first (112 vs 60 months). In four patients the two diagnoses were made simultaneously, on the same histologic specimen in two. Histologic diagnoses of NHL included diffuse large B cell in 6, T cell lymphoma in 4 (peripheral unspecified 2, cutaneous 2), follicular in 3, marginal in 3 and lymphocytic in 4 cases each. T cell, marginal and lymphocytic lymphoma were overrepresented in comparison with their general frequency among NHL. No differences emerged regarding the timing of NHL occurrence, except for lymphocytic lymphoma which never occurred after HL. Nodular sclerosis was the most frequent histologic subtype of HL, representing 58% of cases, whereas only two cases (10%) were nodular lymphocyte predominance HL (NLPHL). Immunohistochemistry on Reed Sternberg cells of HL classical type showed CD30+ in 16 (100%) and CD15+ in 10 (63%) of 16 evaluable cases. CD20+ was present in 3/14 classical HL (21%) and in the 2 cases of NLPHL. Clinical presentation of HL was more aggressive than expected with no patient in stage I, 60% of patients in advanced stage (stage II: 8, stage III: 6; stage IV: 6) and 50% with systemic symptoms. There were no differences between cases presenting as first or second lymphoma. Among NHL 15 cases presented in stage III/IV and 6 with systemic symptoms. In seven cases autoimmune abnormalities/disease coexisted, including Raynaud, thyroiditis, cutaneous lupus, and vasculitis. HL patients were treated with ABVD in 11 cases, or with other chemotherapy programs +/− radiotherapy. NHL received treatments according to histology. In composite lymphoma treatment was directed against the more aggressive lymphoma. In spite of the unfavourable presentation, the complete response rate (CRR) in HL was 74% and the overall response rate (ORR) 79%. It was worse (5/8: 63%) when HL presented after NHL. In NHL the CRR was 63% and the ORR 95%. Relapse occurred in 2 HL, in one composite lymphoma (HL+FL > DLBCL) and in 5 NHL. Seven patients died, with active disease in 6 (2 HL, 4 NHL). One patient died of lung cancer. With a median follow up of 6 years, the 5-year and 10-year survival are 83,5% +/−9% and 68%+/−12%, respectively. We conclude that the occurrence of HL and NHL in the same patient is not rare. T-cell, marginal and lymphocytic lymphoma seem to be more frequently associated with HL. Pathologic and immunohistochemical characteristics are otherwise not distinctive. Patients present with advanced disease and systemic symptoms but their response to treatment and overall prognosis seem not worse than that of patients affected by HL as single tumour. The selective association between some histologic types of NHL and HL as well as the possible association with autoimmunity warrants further investigation. Disclosures: No relevant conflicts of interest to declare.

Fludarabine, Mitoxantrone and Rituximab (FMR) Regimen in Previously Untreated Patients with Indolent Non-Hodgkin Lymphoma: Efficacy, Safety and PET Data On 285 Patients.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2736-2736
Author(s):  
Pier Luigi Zinzani ◽  
Cinzia Pellegrini ◽  
Enrico Derenzini ◽  
Alessandro Broccoli ◽  
Letizia Gandolfi ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Lymphoblastic Leukemia ◽  
Bone Marrow Involvement ◽  
Stage Ii ◽  
Hematologic Toxicity ◽  
Free Survival ◽  
Non Hodgkin Lymphoma ◽  
Significant Difference ◽  
Grade 3

Abstract Abstract 2736 In this retrospective single-center study we aimed at evaluating the efficacy and safety of fludarabine, mitoxantrone and rituximab (FMR) regimen as first line therapy in untreated patients with follicular non-Hodgkin lymphoma (NHL) and indolent non-follicular NHL considering also the role of positron emission tomography (PET) after this chemo-immunotherapy induction as predictor of survival. Between January 2000 and May 2011, 285 patients with stage II-IV untreated indolent follicular (excluding grade IIIb) NHL (n=142) and indolent non-follicular (including marginal zone lymphoma, MZL [n=111] and small lymphocytic lymphoma, SLL [n=31]) NHL (n=143) were diagnosed and treated at our institution in the outpatient clinic. Median age was 63 years (range, 25–83 years) and the median time from diagnosis to study entry was 3 months (range, 1–5 months). 20 patients had stage II, 75 patients had stage III, and 190 had stage IV disease (155 patients had bone marrow involvement). Standard fludarabine (25 mg/m2 iv on days 2, 3 and 4), mitoxantrone (10 mg/m2 iv on day 2) and rituximab (375 mg/m2 iv on day 1) were given every 28 days for six cycles. Globally, after FMR regimen, the overall response rate (ORR) was 83.2%, including a 71.6% complete remission (CR) rate (204 patients) and a 11.6% partial remission (PR) rate (33 patients). According to the histology, in the follicular subset, the ORR was 81.1% with a CR rate of 69.2% while in the indolent non-follicular subset the ORR was 85.2% with a CR rate of 73.9%. In particular, in the indolent non-follicular NHL subgroup the CR rate was 80.2% in MZLs and 51.6% in SLLs, respectively. Toxicities were generally mild and mainly hematologic. Overall 88 (30.8%) patients had grade ≥3 hematologic toxicity, and 26 (9.1%) patients had non-hematologic toxicity with 3 cases of grade ≥3 (1 neurologic toxicity and 2 hepatic toxicity). In terms of secondary malignancies, only 3 (1.0%) hematologic neoplasms were reported (1 myelodisplastic syndrome after 9 months from the end of the treatment and 2 acute lymphoblastic leukemia after 8 and 11 months from the end of the treatment, respectively). Globally with a median follow up of 40 months (range, 12–144 months), at 11 years the overall survival (OS) was 78.8%, the disease-free survival (DFS) was 73.4% (with only 29 relapses), and the progression-free survival (PFS) was 71.9%. Regarding the comparison between the two subsets, follicular vs indolent non-follicular, no statistically significant differences were observed in OS, DFS and PFS curves. Furthermore, a sub-sample of 132 patients (75 follicular NHLs and 57 indolent non-follicular NHLs) had a PET evaluation before the treatment (staging) and 4 to 6 weeks after completion of the sixth cycle of chemo-immunotherapy (restaging, final PET [f-PET]). Post-induction PET-positive patients had a significantly inferior OS at 6 years: 71.4% compared with 98.4% for f-PET-negative patients (p<0.0001, Figure 1a). In terms of PFS at 6 years, there was not a statistically significant difference among f-PET-positive patients and f-PET-negative patients (Figure 1b). Figure 1a. Figure 1a. Figure 1b. Figure 1b. In conclusion, this study suggests and confirms that FMR is a very active, well tolerated (in terms of acute and long-term side effects) chemo-immunotherapy front-line treatment for follicular NHL and indolent non-follicular NHL. PET status at the end of this chemo-immunotherapy induction is quite controversial as a predictor of survival. Disclosures: No relevant conflicts of interest to declare.

Fludarabine, Aracytine and Rituximab Based Chemotherapy In Patients with Refractory and Relapsed Mantle Cell Non-Hodgkin Lymphoma

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4892-4892
Author(s):  
Tommasina Perrone ◽  
Francesco Gaudio ◽  
Annamaria Giordano ◽  
Paola Curci ◽  
Alessandro Spina ◽  
...  
Keyword(s):  
Mantle Cell Lymphoma ◽  
Hodgkin Lymphoma ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Bone Marrow Involvement ◽  
International Prognostic Index ◽  
Single Agent ◽  
High Dose ◽  
Non Hodgkin Lymphoma ◽  
Mantle Cell

Abstract Abstract 4892 Introduction Mantle cell lymphoma (MCL) is a distinct B cell non Hodgkin lymphoma characterized by CD 5 expression, t (11; 14)(q13; q32) translocation and over-expression of Cyclin D1, and frequently has an aggressive clinical course. There is no standard of care for the treatment of MCL. Current treatment approaches are non curative and pts median survival is 4–6 years. Various studies have reported promising results for a high dose Cytarabine-containing regimen in the treatment of MCL. Fludarabine has also been recognized as effective treatment in pts with MCL, either as a single agent or in combination with other drugs. The addition of Rituximab improves the response to the treatment. The aim of this study is to assess the efficacy and toxicity of a combination of Fludarabine, Aracytine and Rituximab treatment in refractory and relapsed MCL. Methods We retrospectively evaluated 20 pts with refractory or relapsed MCL treated in our institution between February 2007 and February 2010. Median age was 59 yrs (54-77 yrs), 14 pts (70%) were males, 18 pts (90 %) had stage IV, 16 pts (80%) had bone marrow involvement, 16 (80%) presented comorbidities. Eight pts (40%) were in first relapse, 12 (60%) in second relapse. Twelve pts (60%) had a “Mantle Cell Lymphoma International Prognostic Index” (MIPI) score ≥ 7. Therapy included: fludarabine 25 mg/m2/daily intravenously for 3 days, aracytine 500 mg/m2/daily for 3 days and Rituximab 375 mg/m2/daily for 1 day, Dexamethasone 8 mg daily for 3 days, every 28 days for 4 cycles. Results Eight pts (40%) achieved complete response (CR) and 4 pts (20%) a Partial Remission (PR) with an overall response rate (ORR) of 60%. Eight pts (40%) progressed and one of them died of active disease. After a median follow up of 17 months (range 8–36), OS is 70% and PFS is 55%. Toxicity was mainly hematological with grade >=3 neutropenia in 40 (50%) of the 80 cycles performed, grade >=2 anemia in 30 (37%) and grade 4 thrombocytopenia in 24 (30%). In 16 (20%) cycles pts required red blood cells transfusions, in 12 (15%) platelet transfusions. One episode of Herpes Zoster infection was observed. Conclusions This study suggests that the combination of Fludarabine, Aracytine and Rituximab appears to be an effective regimen with a promising response rate and manageable toxicity, for pretreated pts often affected by comorbidities and with poor prognosis. Further studies are needed to assess the efficacy of this combination therapy and to further test the role of this approach in MCL. Disclosures: No relevant conflicts of interest to declare.

Randomized Comparison of Cladribine Single (C) or in Combination with Cyclophosphamide (CC), and COP in Previously Untreated Low Grade B-Cell Non-Hodgkin Lymphoma Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2481-2481
Author(s):  
E. Kalinka ◽  
J. Wajs ◽  
K.S. Sulek ◽  
M. Blasinska-Morawiec ◽  
P. Centkowski ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Low Grade ◽  
Non Hodgkin Lymphoma ◽  
Not Otherwise Specified ◽  
Ann Arbor ◽  
To Receive

Abstract To comparatively assess first-line treatment with cladribine single (C) or in combination with cyclophosphamide (CC), and COP (cyclophosphamide, vincristine, prednisone) in low grade B-cell non-Hodgkin lymphoma (NHL), previously untreated patients (pts) with Ann Arbor stage II-IV were randomly allocated to receive 6 monthly courses of either C, CC, or COP. End points were treatment response, freedom from progression (FFP) and overall survival (OS), and tolerance. From June 1, 2000 to June 30, 2005, 196 pts were randomized in 17 centers. Of 153 pts for whom data is available, 55 (36%) were diagnosed as small lymphocytic, 11 lymphoplasmocytoid (7%), 37 marginal-zone (24%), 42 follicular (27.5%), and 8 not otherwise specified low grade B-cell NHL (5.5%). Randomization constituted comparable groups, including International Prognostic Index variables. Compared to C and CC, COP induced lower overall response rates (75%, 90%, 50%, χ2 =7.9 p<.005), including lower complete remission rates (38%, 62%, 9.5%, χ2=19.2 p<.0001). With a median follow-up of 15 months, FFP was superior in patients receiving cladribine-containing regimens (χ2 = 21.8, log-rank p<.0001). No difference in median OS was observed. Incidences of infections (9% versus 3.5% versus 7%) and non-hematological side effects (7.5% versus 3.5% versus 7%) were similar in the randomized groups, whereas CC but not C induced more frequent peripheral cytopenias compared to COP (30% versus 11%, p=.034). This resulted in higher frequency of prolongation of intervals between CC versus COP treated pts (respectively 45% and 21%, χ2=6.04 p=.014) and C versus CC treated pts (respectively 26% and 45%, χ2=4.24, p=.039). Dose reductions because of hematological or other toxicity were comparable in C (9.5%), CC (20%), and COP (21%) groups. Although final results warrant completed data for all randomised pts with longer follow-up, similar tolerance and higher efficacy of cladribine-based regimens over COP provide rationale to combine C or CC with rituximab in future clinical trials.

scholarly journals Variability Of Performance Status Assessment Between Patients With Hematologic Malignancies and Their Physicians

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 1703-1703
Author(s):  
Alexis D Leal ◽  
Cristine Allmer ◽  
Matthew J Maurer ◽  
Tait D Shanafelt ◽  
James R Cerhan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Prognostic Score ◽  
Performance Status ◽  
International Prognostic Index ◽  
Eastern Cooperative Oncology Group ◽  
Aggressive Disease ◽  
C Statistic ◽  
Ecog Ps

Abstract Background Performance status (PS) is a measurement of a patient’s functional capabilities and has been validated as a prognostic indicator in patients with cancer. This study was conducted to compare patient and physician-rated Eastern Cooperative Oncology Group (ECOG) PS to determine the incidence of inter-observer variability and identify determinants of PS disagreement among a cohort of patients with hematologic malignancy. Methods Newly diagnosed patients with leukemia and lymphoma were prospectively enrolled in the University of Iowa/Mayo Clinic SPORE Molecular Epidemiology Resource (MER) from 2002-2008. At diagnosis, patients and their physicians were asked to independently rate ECOG PS. Those who reported PS within 1 month of diagnosis were included in this analysis. Chi-squared and Wilcoxon rank-sum tests were used to assess the association between PS disagreement and prognostic or demographic factors; Cox proportional hazards models and c-statistics were used to evaluate the association between PS and overall survival. Results 1269 patients were included with a median age of 61 years (range 18-91). Of these, 58% were male; 275 had chronic lymphocytic leukemia (CLL), 127 had Hodgkin lymphoma (HL), and 867 had non-Hodgkin lymphoma (NHL). Overall, 829 (65%) patients and physicians rated PS the same. Age greater than 60 was a significant predictor of disagreement overall (p<0.001), as well as in CLL (p=0.014) and NHL (p=0.004), but not in HL (p=0.65). We found that across disease subtypes, the level of disagreement increased with more aggressive disease. This finding was significant in those with HL (p=0.027) and NHL (p<0.0001) as International Prognostic Score (IPS) and International Prognostic Index (IPI) increased respectively. In CLL, the trend for Rai stage was suggestive but not statistically significant (p=0.27). The incidence of disagreement was highest among patients with NHL (37%), with a higher percentage of disagreement among those with aggressive (45%) vs. non-aggressive (25%) subtypes (p<0.001). Disagreement was lower in patients with CLL (27%) and HL (33%). There were no significant associations between patient gender or education level and PS rating among subtypes or overall. Patient and physician-rated PS were both significant predictors of overall survival in univariate models and also adjusted for subtype and subtype specific risk score. The prognostic ability for PS was similar for both patient rated and physician-rated assessment overall (c-statistic=0.76 for both patient and physician rated PS) and in those with HL (c-statistic=0.85 for both patient and physician rated PS) and NHL (c-statistic=0.76 for both patient and physician rated PS). However, patient-rated PS was better for prognostication in CLL (c-statistic=0.75; p<0.0001), compared to physician-rated PS (c-statistic=0.67; p=0.002). Conclusions Patients with hematological malignancies and their physicians do not always rate PS the same, particularly in patients who are older or have more advanced or aggressive disease. These findings suggest the need for physicians to communicate with patients when determining PS, as PS is a strong predictor of survival. Disclosures: No relevant conflicts of interest to declare.

Treatment modalities of non-Hodgkin lymphoma patients over 65 years of age: A two-center experience

2019 ◽  
Vol 26 (1) ◽  
pp. 99-104 ◽  
Author(s):  
Guven Cetin ◽  
Elif Ece Dogan ◽  
Nilay Sengul Samanci ◽  
Mesut Ayer ◽  
Tuba Ozkan ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Eastern Cooperative Oncology Group ◽  
Prognostic Index ◽  
Disease Free Survival ◽  
B Cell Lymphoma ◽  
Treatment Modalities ◽  
Oncology Group ◽  
Non Hodgkin Lymphoma

Objective This study was conducted with the aim of making the contribution to a decision for treatment and determination of the modalities in patients diagnosed with non-Hodgkın lymphoma which increasingly become widespread in the geriatric population. Materials and methods Ninety-one patients aged over 65 years diagnosed with lymphoma and treated in Bezmialem Vakıf University Medical Faculty Hospital and Haseki Training and Research Hospital between 2008 and 2013 were retrospectively evaluated. Finally, 63 patients for whom data could be reached were included in the study. Results Examining the results, histological diagnoses of our patients were as follows: diffuse large B-cell lymphoma (50.8%), follicular lymphoma (23.8%), marginal zone lymphoma (12.7%), mantle cell lymphoma (4.8%), T-cell lymphoma (4.8%), lymphoplasmacytic lymphoma (1.6%) and small lymphocytic lymphoma (1.6%). Stages at the time of diagnosis were early stage by 33.3% and late stage by 66.7%. Of the patients, 36.5% had a low-intermediate and 63.5% a high-intermediate International Prognostic Index score. According to the Eastern Cooperative Oncology Group scoring, 34.9% of the patients have an Eastern Cooperative Oncology Group score of 2–4. Activities of daily living score of 33.3% patients was under 5. Looking at the responses to treatment, the complete response was found in 50.8%, partial response in 4.8%, stable disease in 1.6% and progressive disease in 9.5% of the patients. The mean follow-up duration of patients was found as 25.2 months and disease-free survival after remission as 20.2 months. Conclusion We found that we have achieved a complete remission in more than half of our patients (50.8%). Based on this, treatment should aim remission in elderly patients.

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