A Decade of Survival: Median Survival Time and Prognostic Factors of Non-Hodgkin Lymphoma in Elderly Patients in Kelantan (2008–2017)

Abstract

Non-Hodgkin lymphoma (NHL) is a major lymphoma subtype in Malaysia and a significant public health burden. Elderly patients often have poorer outcomes due to late presentation, comorbidities, and reduced treatment tolerance. This study examined median survival time and prognostic factors of death among NHL patients aged ≥60 years in Kelantan. A retrospective cohort was conducted using Kelantan Cancer Registry data from 2008–2017, with follow-up until December 2022. Mortality status was verified through the National Registration Department. Kaplan–Meier methods estimated survival, and Cox regression identified prognostic factors. Among 156 patients, 95 (60.9%) were male and 150 (96.2%) Malay. The median age was 67 years (IQR: 12). Most had Mature B-cell lymphoma (74.4%), and 89.1% were aggressive types. The overall median survival time was 4.18 months (95% CI: 2.26–6.08). Stage IV disease showed higher risk (Adj. HR: 2.33, 95% CI: 0.87–6.27, p=0.092). Patients without chemotherapy had significantly increased mortality (Adj. HR: 1.58, 95% CI: 1.02–2.43, p=0.040). Survival outcomes for elderly NHL patients were poor, highlighting the need for earlier diagnosis, improved access to chemotherapy, and lifestyle-based supportive care to enhance quality of life.