BACKGROUND AND OBJECTIVES: In general, elderly patients with Hodgkin's lymphoma (HL) have a less favorable prognosis than do younger ones. Inadequate therapy, often due to decreased tolerance to treatment, contributes to the poor outcome. This study was undertaken to evaluate potential clinical factors of importance for prognosis with special reference to relative dose intensity (RDI) of chemotherapy (CT). DESIGN AND METHODS: Eighty-eight consecutive elderly (>60 years) HL patients diagnosed between 1973-1994 who received up-front CT+/-radiotherapy (RT) were included (median age 72 years, range 60-92; median follow-up time 78 months, range 49-206). The calculations of RDI of CT were based on Hryniuk's model. RESULTS: The 5-year overall (OS) and cause-specific (CSS) survival was 39% and 51%, respectively, in patients who received CT+/-RT. Nine of the 14 patients who only received 1 cycle of CT died within 6 months from diagnosis without achieving complete remission (CR). However, the remaining 5 patients in this group survived 14-97+ months. Patients with a RDI >65% had a significantly better OS (p=0.029) and CSS (p=0.024) than those with a RDI 65%. Patients who received ABVD-based CT with a RDI >65% had a significantly better OS (p=0.0011) than those who were treated with ABVD-based CT with a RDI 65%, or MOPP-like therapy, irrespective of received RDI. INTERPRETATION AND CONCLUSIONS: Prognosis remains heterogeneous and the significance of established prognostic factors is limited in elderly HL patients. Patients who received a low RDI of CT and those receiving non-ABVD-based treatment fared worse. However, also elderly patients can enjoy long-standing complete remission following minimal treatment.
BACKGROUND AND OBJECTIVES: In general, elderly patients with Hodgkin's lymphoma (HL) have a less favorable prognosis than do younger ones. Inadequate therapy, often due to decreased tolerance to treatment, contributes to the poor outcome. This study was undertaken to evaluate potential clinical factors of importance for prognosis with special reference to relative dose intensity (RDI) of chemotherapy (CT). DESIGN AND METHODS: Eighty-eight consecutive elderly (>60 years) HL patients diagnosed between 1973-1994 who received up-front CT+/-radiotherapy (RT) were included (median age 72 years, range 60-92; median follow-up time 78 months, range 49-206). The calculations of RDI of CT were based on Hryniuk's model. RESULTS: The 5-year overall (OS) and cause-specific (CSS) survival was 39% and 51%, respectively, in patients who received CT+/-RT. Nine of the 14 patients who only received 1 cycle of CT died within 6 months from diagnosis without achieving complete remission (CR). However, the remaining 5 patients in this group survived 14-97+ months. Patients with a RDI >65% had a significantly better OS (p=0.029) and CSS (p=0.024) than those with a RDI 65%. Patients who received ABVD-based CT with a RDI >65% had a significantly better OS (p=0.0011) than those who were treated with ABVD-based CT with a RDI 65%, or MOPP-like therapy, irrespective of received RDI. INTERPRETATION AND CONCLUSIONS: Prognosis remains heterogeneous and the significance of established prognostic factors is limited in elderly HL patients. Patients who received a low RDI of CT and those receiving non-ABVD-based treatment fared worse. However, also elderly patients can enjoy long-standing complete remission following minimal treatment.
Authors: Sameer A Parikh; Thomas M Habermann; Kari G Chaffee; Timothy G Call; Wei Ding; Jose F Leis; William R Macon; Susan M Schwager; Kay M Ristow; Luis F Porrata; Neil E Kay; Susan L Slager; Tait D Shanafelt Journal: Am J Hematol Date: 2015-01-30 Impact factor: 10.047
Authors: Victor M Orellana-Noia; Krista Isaac; Mary-Kate Malecek; Nancy L Bartlett; Timothy J Voorhees; Natalie S Grover; Steven R Hwang; N Nora Bennani; Rachel Hu; Brian T Hill; Eric Mou; Ranjana H Advani; Jordan Carter; Kevin A David; Hatcher J Ballard; Jakub Svoboda; Michael C Churnetski; Gabriela Magarelli; Tatyana A Feldman; Jonathon B Cohen; Andrew M Evens; Craig A Portell Journal: Blood Adv Date: 2021-09-28
Authors: Ercole Brusamolino; Andrea Bacigalupo; Giovanni Barosi; Giampaolo Biti; Paolo G Gobbi; Alessandro Levis; Monia Marchetti; Armando Santoro; Pier Luigi Zinzani; Sante Tura Journal: Haematologica Date: 2009-03-10 Impact factor: 9.941
Authors: Andrew M Evens; Fangxin Hong; Leo I Gordon; Richard I Fisher; Nancy L Bartlett; Joseph M Connors; Randy D Gascoyne; Henry Wagner; Mary Gospodarowicz; Bruce D Cheson; Patrick J Stiff; Ranjana Advani; Thomas P Miller; Richard T Hoppe; Brad S Kahl; Sandra J Horning Journal: Br J Haematol Date: 2013-01-29 Impact factor: 6.998
Authors: Catherine S Diefenbach; Hailun Li; Fangxin Hong; Leo I Gordon; Richard I Fisher; Nancy L Bartlett; Michael Crump; Randy D Gascoyne; Henry Wagner; Patrick J Stiff; Bruce D Cheson; Douglas A Stewart; Brad S Kahl; Jonathan W Friedberg; Kristie A Blum; Thomas M Habermann; Joseph M Tuscano; Richard T Hoppe; Sandra J Horning; Ranjana H Advani Journal: Br J Haematol Date: 2015-09-07 Impact factor: 6.998