Background: Elderly patients with non-Hodgkin’s
lymphoma (NHL) are often not treated with standard
immunochemotherapy and this might have a negative
impact on their survival. Little is known about the
determinants that play a role in treatment decision-making of clinicians regarding elderly patients with NHL. The objective of this study was to gain more insight into these determinants. Methods: A survey was conducted amongst haematologists in the Netherlands. The survey contained questions about comorbidity, polypharmacy, social setting, nutritional status, depression, mild cognitive impairment, dementia, activities of daily living (ADL) and instrumental activities of daily living (IADL) in relation to treatment decisions in elderly NHL patients.
Results: Of all comorbidities, respondents designated
cognitive disorders and cardiovascular comorbidity as
the most important factors when assessing whether an
older patient with NHL is eligible for curative treatment.
Also in decreasing degree of importance ADL, IADL and
depressive disorder are frequently included in treatment
decision-making. Almost half of the respondents feel that
treatment of the elderly person is complicated as a result of a lack of scientific evidence. Conclusion: Haematologists are aware of coexisting problems in elderly patients and they frequently take comorbidities, cognitive disorders and functional status into consideration in treatment decision-making. Future studies are needed to determine the exact role that these
factors should play in the treatment of elderly patients.
Furthermore, haematologists feel that treatment of the
elderly is complicated and there is a lack of scientific
evidence, and therefore older adults should be better
represented in clinical trials.