Indolent non-Hodgkin lymphomas in the elderly

Abstract

Introduction. Indolent non-Hodgkin lymphoma (NHL) is a lymphoid tumor with increasing morbidity with age. The objective of the study was to assess the clinical and hematological features of indolent NHL in elderly patients. Material and methods. The study included patients older than 60 years with indolent NHL, treated in the Oncological Institute, Chisinau, Republic of Moldova. The diagnosis of indolent NHL was established according to the International Histological and Cytological Classification of Hematopoietic and Lymphatic Tissue Pathologies proposed by the World Health Organization in 2016. In all patients, clinical examination, imaging investigations, blood tests, bone marrow aspiration and biopsy were performed. Results. The study included 53 elderly patients: 33 women, 20 men. Marginal zone lymphoma (MZL) predominated in men (70.8%), follicular lymphoma (FL) in women (62.5%), small lymphocytic lymphoma (SLL) had almost the same frequency (49.4% and 50.6%) in men and women. In 53% of cases the onset was in lymph nodes. Advanced stages were diagnosed in 83.8% of cases. Bone marrow involvement was detected in 63.2% of cases. Conclusions. In our group of study, the most frequent form were SLL, regardless of patients’ gender. The onset of indolent NHL occurred more frequently in lymph nodes, mainly in peripheral ones. Independent of the indolent NHL type, the tumour spreads especially in the regional lymph nodes. The involvement of different extra-nodal areas was not identical: the bone marrow was affected most frequently, followed by liver and more rare other organs and tissues. Due to the low degree of malignancy, the extramedullary multiplication of malignant lymphoid cells is slow.

Keywords

• non-hodgkin lymphoma
• indolent
• elderly patient