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The Clinical Challenge of Non-Hodgkin’s Lymphoma in the Elderly

Alexandra Nevin, BSc

It is predicted that 70% of all neoplasms will occur in the geriatric population by the year 2020.1 Hematologic malignancies represent a significant and clinically devastating proportion of the cancers affecting the sixty-five-plus generation. Within the spectrum of lymphoid-derived hematologic tumors, the umbrella class referred to as non-Hodgkin's lymphoma (NHL) is particularly daunting in terms of both incidence and associated mortality in the general population. Since the 1970s, the National Cancer Institute reports that NHL is one of only five malignancies for which death rates have increased, while the American Cancer Society reports that the absolute incidence of NHL has increased over 65% in the past 30 years. The determination of age-adjusted incidence rates indicates that such trends are due primarily to increases in NHL among older persons.2 From a clinical perspective, elderly NHL patients represent a unique group due to the demonstration of certain age-specific characteristics, including histology type predominance, prognosis, and response to current conventional treatment. Recent advances, such as monoclonal antibody treatment, represent a promising therapeutic avenue in future treatment of specific forms of NHL in the elderly.

The Etiology of NHL
The underlying etiology of most types of NHL is still unknown, regardless of the patient's age. However, a number of risk factors have been identified for the general population.