Steroids are used in the treatment of patients with non-Hodgkin's lymphoma (NHL) as a one off high dose and are a key antitumor medication. Although the duration of steroid administration is short, Steroid Withdrawal Syndrome (SWS) has been documented after treatment. The aim of this retrospective study was to evaluate the prevalence of SWS and to assess the relevance of steroid tapering in 116 patients newly diagnosed with NHL. The most significant symptoms of SWS documented were fatigue in 70 patients (60.3%) and anorexia in 32 (27.6%). Four elderly patients (3.4%) suffered with serious SWS symptoms of grade 3. Of the 70 patients suffering with SWS, 22 went on to receive tapered steroid therapy during the subsequent chemotherapy treatment. The average steroid tapering period was 4.4 days and 86.4%patients reported a significant improvement of their SWS symptoms. No serious adverse events were noted. Although age did not appear to be a risk factor of SWS it was noted that elderly patients with SWS were more adversely affected.
We conclude that steroid tapering is a safe and effective treatment method. If the patient has serious symptoms of SWS we should introduce steroid tapering aggressively and early, especially in elderly patients.