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Follicular lymphomas in vulnerable/older patients
- Source :
- Current Opinion in Oncology. 31:380-385
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Unlike for diffuse large-cell lymphoma, both the management of elderly patients with follicular lymphoma and the role of comprehensive geriatric evaluation to optimize treatment choices have been rarely addressed. This review analyses available evidence on follicular lymphoma occurring in aged persons.Most retrospective studies and expert recommendations agree that the diagnostic approach and the treatment algorithm in elderly follicular lymphoma should not differ from younger patients up to the age of 80. However, slowly progressing follicular lymphoma low-tumor burden should start treatment even though asymptomatic. Prospective identification of those unfit patients is needed where a treatment deintensification may not be detrimental. Octogenarians have more aggressive disease and do not benefit from chemoimmunotherapy more than from single-agent rituximab. An activity of daily living loss significantly impact on their outcome and specific prognostic scores may help in the better manage these oldest patients.Given the lack of prospective studies there is an urgent need to investigate if geriatric assessment including comorbidities, geriatric parameters, patient's reported outcomes and quality of life issues, may help selecting those frail elderly follicular lymphoma patients less suitable for full-dose treatments. In addition, the potential usefulness of the new noncytotoxic agents of proven efficacy in follicular lymphoma warrants specific investigations in older patients.
- Subjects :
- 0301 basic medicine
Oncology
endocrine system
Cancer Research
medicine.medical_specialty
MEDLINE
Follicular lymphoma
03 medical and health sciences
0302 clinical medicine
Older patients
immune system diseases
hemic and lymphatic diseases
Internal medicine
Follicular phase
medicine
Humans
Geriatric Assessment
Lymphoma, Follicular
Aged
Neoplasm Staging
Randomized Controlled Trials as Topic
Aged, 80 and over
Treatment choices
business.industry
Age Factors
Middle Aged
medicine.disease
Lymphoma
030104 developmental biology
030220 oncology & carcinogenesis
Neoplasm staging
business
Subjects
Details
- ISSN :
- 10408746
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Current Opinion in Oncology
- Accession number :
- edsair.doi.dedup.....42458b24220f7257638fbb09e7aed440