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Annals of Oncology 13:1275-1284, 2002
© 2002 European Society for Medical Oncology

Original Paper

Age-related differences among patients with follicular lymphoma and the importance of prognostic scoring systems: analysis from a population-based non-Hodgkin’s lymphoma registry

E. Maartense1,+, S. le Cessie2, H. C. Kluin-Nelemans3, P. M. Kluin4, S. Snijder5, P. W. Wijermans6 and E. M. Noordijk7

1 Department of Internal Medicine, Reinier de Graaf Gasthuis; 2 Department of Medical Statistics, Leiden University Medical Center, Leiden; Departments of 3 Haematology and 4 Pathology, Academic Hospital Groningen, Groningen; 5 Comprehensive Cancer Center West, Leiden; 6 Department of Haematology, Leyenburg Hospital, The Hague; 7 Department of Clinical Oncology, Leiden University Medical Center, Leiden, The Netherlands

Received 2 January 2002; accepted 14 January 2002

Background:

The influence of age on the outcome of follicular non-Hodgkin’s lymphoma (FL) was studied in a population-based non-Hodgkin’s lymphoma registry.

Patients and methods:

This study comprised 214 follicular lymphoma patients. Grade I/II was considered separately from grade III FL. The data were analyzed with respect to three age groups: <60, 60–69 and >=70 years.

Results:

The overall survival rate decreased in the older age groups. Grade III patients showed a statistically significant decrease in overall survival in comparison with grade I/II patients (P = 0.03). Cause-specific survival analysis showed that in the older age groups, there was an increasing influence of concomitant disease on the death rate, especially among grade III FL patients >70 years of age. The survival curve in grade III FL patients was shown to reach a plateau. The prognostic scoring system, according to the Italian Lymphoma Intergroup, fitted better to grade I/II patients, while the International Prognostic Index showed better discrimination amongst grade III patients.

Conclusions:

Separate grading for follicular lymphoma is useful. An age >70 years has a negative impact on outcome, but the contribution of concomitant disease herein is important. Different prognostic scoring systems should be applied to the different grades of FL.

Key words: cause-specific survival, elderly patients, follicular lymphoma, prognostic score


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