Outcome of elderly patients with aggressive Non-Hodgkin's lymphoma refractory to or relapsing after first-line CHOP or CHOP-like chemotherapy: a low probability of cure.

We retrospectively evaluated the outcome of 94 consecutive elderly patients treated at our center for an aggressive lymphoma without a low-grade component. Median survival was 26 months and 5-year overall survival was 39% (27-50%). We then evaluated the outcome of patients refractory to or relapsing after CHOP or CHOP-like chemotherapy. Twenty patients were refractory to first-line therapy and only 1/20 is alive with active lymphoma. Eight patients achieved a partial response and only 3 maintained the partial response while the other 5 patients died. Only 2 of the 27 patients who relapsed after a first complete remission achieved a second sustained complete remission. This study suggests that conventional-dose second-line chemotherapy yields disappointing results in elderly patients with aggressive lymphomas.