Role of Anemia in Survival of Elderly Aggressive Non-Hodgkin’s Lymphoma Patients Following Chemotherapy.

Recent literature data suggest that baseline anemia is an important poor prognostic factor for non-Hodgkin’s lymphoma (NHL) outcome. We evaluated the prevalence, risk factors, and prognostic value of anemia following chemotherapy in elderly patients with aggressive NHL treated with conventional front-line chemotherapy. Patients and Methods. The retyrospective sample included 168 patients with diagnosis of aggressive NHL treated between March 1993 and February 2001 with VNCOP-B regimen in five italian institutions. The model included sex, age, hemoglobin level following chemotherapy, and response to chemotherapy. Tumor remission at the end of chemotherapy was associated to a highly significant reduction in risk (RR, 0.215; p=0.0001); advanced staging before chemotherapy independently predicted a poorer survival (II-IV vs. I-II; RR, 1.55; p=0.0023). The prognostic value of hemoglobin level at chemotherapy end, adjusted for all above factors, was statistically significant (RR for 1-g/dL increment, 0.76; p= 0.0041). Our preliminary results suggest the prognostic role of hemoglobin value after chemotherapy in terms of overall survival. This concept introduces the potential role of anemia correction in improving the survival rate in elderly aggressive NHL.