Impact of severe side effects on outcomes of older patients with non-Hodgkin lymphoma

This study examined whether newer therapies for non-Hodgkin lymphoma (NHL) were associated with higher odds of negative side effects in older patients. The study concluded that NHL patients over age 65 experienced more serious side effects than younger patients, and these side effects were associated with worse outcomes.

Non-Hodgkin lymphoma is commonly diagnosed in older patients. The average age at diagnosis is over age 65. Treatments such as chemotherapy and immunotherapy (treatments that stimulate the immune system to fight against cancer cells) have improved outcomes in many. Older age, however, is associated with poorer outcomes. This may be due in part to other conditions (comorbidities), including cardiovascular disease and pulmonary (lung) disease. Comorbidities can make it more difficult for patients to tolerate treatments, or may lead to under-treatment.

Newer treatment options, such as therapies that target proteins involved in cancer growth, are now available for many patients. It is not clear how frequently negative side effects occur with these new treatments in older adults with NHL.

This study examined the side effects associated with new therapies in older patients with NHL. The records of 1199 patients who took part in clinical trials were analyzed. Of these, 463 patients had NHL and 736 had chronic lymphocytic leukemia. 34.1% of patients were 65 or older. Patients were treated with newer, targeted therapies alone, or combined with chemotherapy.

Overall, 35% of patients with NHL experienced one or more serious or severe blood-related side effect (such as low levels of certain blood cells). 54% experienced a serious or severe side effect not related to blood.

There was no significant difference in the odds of severe or serious blood-related side effects between age groups. The odds of non-blood-related side effects were 89% higher for older patients compared to younger.

The odds of a shorter survival were 3.14-times higher for older patients who experienced at least one serious to severe side effect in the first three months of treatment. Older patients also had 3-times higher odds of a shorter time to disease progression.

The study concluded that NHL patients over age 65 experienced more serious side effects than younger patients, and these side effects were associated with worse outcomes.