Investigation of treatment pattern, medical resource utilization and demographic prognostic factors in older patients with non-Hodgkin lymphoma: A nationwide population-based study

Background: This nationwide population study aimed to investigate treatment patterns, medical resource utilization and demographic prognostic factors in older Taiwanese patients with non-Hodgkin lymphoma (NHL). Patients and Methods: This study was conducted using the National Health Insurance Research Database (NHIRD) of Taiwan. The older patients (65 years or older) diagnosed with NHL between 1997 and 2008 were identified for analysis. Results: A total of 5136 patients (3049 males and 2087 females) with a median age of 74.1 years were identified for analysis. Among these patients, 3267 patients (63.6%) received various combinations of systemic therapies. The older the patient, the less likely it was for intensive curative treatment to be given. Regarding medical resource usage, younger patients or patients living in more urbanized areas were more likely to receive NHL treatment in medical centers. The median overall survival of all patients with NHL was 49.41 months (range, 0.03 to 143.97). The investigation for prognostic factors by multivariate analysis revealed that more advanced age, treatment in non-medical centers and living in less urbanized areas were associated with poorer outcomes. Conclusion: Treatment of older patients with NHL is still a challenge. For better outcomes, it is very important to evaluate the patient and tailor treatment modalities. Additionally, health policy makers should help to narrow discrepancies in survival based on demographics. (C) 2018 Elsevier Ltd. All rights reserved.