超高龄非霍奇金淋巴瘤患者临床预后及相关因素探讨

Clinical prognosis and related factors of advanced-aged patients with non-Hodgkin's lymphoma

目的探讨超高龄住院患者非霍奇金淋巴瘤的临床预后及其相关因素。方法回顾性分析2019年8月至2021年8月广州市第一人民医院老年病科超高龄患者(平均年龄大于80岁)的治疗方案、血生化指标和临床预后的相关因素进行分析。结果本研究共纳入128例非霍奇金淋巴瘤患者,其中男性68例,女性60例,年龄为(88.5±5.5)岁。82.0%(105/128)患者年龄超过75岁,48.4%(62/128)患者处于AnnArbor分期Ⅲ期及以上,54.7%(70/128)患者表现出B症状。2年的总体生存率为68.8%(88/128)。使用R-CHOP化疗方案者占比43.8%(56/128),使用CHOP方案者为23.4%(30/128),不能耐受方案中断和拒绝化疗者32.8%(42/128)。2年内死亡40例,病死率为31.3%。高龄及合并冠心病可能和死亡相关,而AnnArborⅢ期及以上者与初选B症状也可能和死亡相关。结论超高龄患者确诊淋巴瘤后,预后较差,积极控制患者的共病等情况有益于改善患者的预后。

Objective To investigate the clinical prognosis and related factors of advanced-aged patients with non-Hodgkin's lymphoma.Methods The treatment plans,blood biochemical indicators,and clinical prognostic factors of the advanced-aged patients with non-Hodgkin's lymphoma(average age>80 years old)treated at Geriatrics Department,Guangzhou First People's Hospital from August,2019 to August,2021 were retrospectively analyzed.Results A total of 128 patients with non-Hodgkin's lymphoma were enrolled in this study,including 68 males and 60 females,with an age of(88.5±5.5).Among the patients,82.0%of the patients(105/128)were over 75 years old,48.4%(62/128)were in Ann Arbor stage III or above,and 54.7%(70/128)presented with symptom B.The overall 2-year survival rate was 68.8%(88/128).R-CHOP was used in 43.8%of the patients(56/128),and CHOP in 23.4%(30/128);and 32.8%of the patients(42/128)stopped the chemotherapy because they were not tolerated or refused.Forty patients died within 2 years,with a mortality rate of 31.3%.Advanced age,coronary heart disease,Ann Arbor stage III or above,and primary B symptoms might be associated with death.Conclusion The prognosis of advanced-aged patients diagnosed with lymphoma is poor,and the active control of comorbidity is beneficial to improve their prognosis.