Predictors of morbidity in lymphoma patients over 75 requiring chemoRx
Research type
Research Study
Full title
Identifying predictors of morbidity in elderly lymphoma patients over 75 requiring chemotherapy
IRAS ID
260084
Contact name
Simona Deplano
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
0 years, 2 months, 1 days
Research summary
Summary of Research
In this project, we will retrospectively review the baseline characteristics and the outcomes and complications of treatment in elderly patients (age 75 years or older) who received chemotherapy for lymphoma/lymphoproliferative disorders at Imperial College Healthcare NHS Trust.
We will identify those features that predict complications of treatment and will collate these characteristics into a "frailty score for patients with lymphoma".
Summary of Results
The dataset was interrogated for patients with highgrade B cell lymphoma who received intensive chemotherapy. The outcomes of a population of well-selected patients over 75 years of age with high grade B cell lymphoma and treated with RCHOP chemotherapy were compared to those of a group of patients who received the same treatment. The success of delivering treatment was similar in both groups, and toxicity was actually lower in the older group - adding further evidence that it is possible to treat older patients with RCHOP chemotherapy if patients are chosen judiciously. There was a trend to more frequent admissions and longer inpatient stays during chemotherapy in the older group.
We analysed the outcomes of our patient group as predicted by the HOF score and were able to demonstrate that the HOF score can be used to assess prognosis in this group of patients.
We examined the dataset for patients with cytopenias in the absence of a molecular or cytogenetic abnormality, and reported on the incidence of copper deficiency in these patients. Copper deficiency was not found to be more likely to be deficient in our cohort, though the sample was a small one. We dont recommend routine measurement of copper levels in all patients with cytopenias, and recommend a risk-assessed approach to this differential.
In patients with cytopenias of mild severity, we analysed the likelihood of a haematological diagnosis on bone marrow biopsy and were able to demonstrate a much higher likelihood of a positive finding in patients with multiple cytopenias and/or cytopenias of moderate severity. We suggest that patients with mild cytopenia should be counselled about the likelihood of a non-diagnostic result if bone marrow biopsy is recommended.
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
19/LO/0825
Date of REC Opinion
22 Aug 2019
REC opinion
Further Information Favourable Opinion