Magnus Björkholm1, Caroline E Weibull2, Sandra Eloranta3, Karin E Smedby3, Ingrid Glimelius3,4, Paul W Dickman2. 1. Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden. 2. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 3. Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden. 4. Department of Immunology, Genetics and Pathology, Clinical and Experimental Oncology, Uppsala University and Uppsala Akademiska Hospital, Uppsala, Sweden.
Abstract
OBJECTIVE: Forty percent of Hodgkin lymphoma (HL) patients are older than 50 years at diagnosis, a fact which is not commonly recognized. Older patients do significantly worse than younger patients and are rarely included in clinical trials. METHODS: Using data from Swedish Cancer and Lymphoma Registries, we estimated relative survival ratios (RSRs) for 7997 HL patients (diagnosed 1973-2013; 45% ≥50 years). RESULTS: The 1-year RSRs (95% confidence interval; CI) for males aged 45-59, 60-69, 70-80, and 81 years and over, diagnosed in 2013, were 0.95 (0.91-0.97), 0.88 (0.81-0.92), 0.74 (0.63-0.81), and 0.52 (0.35-0.67), respectively. The corresponding 1-year RSRs for females were 0.97 (0.94-0.98), 0.91 (0.85-0.95), 0.82 (0.73-0.88), and 0.66 (0.50-0.77). No improvements in 1-year of 5-year relative survival from 2000 to 2013 were observed for patients aged 45-59 or 60-69 but there were modest improvements for patients aged 70 years and older. Importantly, we saw no changes in the distribution of disease or patient characteristics between 2000 and 2013. CONCLUSIONS: Elderly patients constitute a large group with clearly unmet medical needs. Our findings motivate a more active approach to including elderly patients in clinical trials. Our study provides a baseline for outcome comparison after the broader introduction of targeted drugs.
OBJECTIVE: Forty percent of Hodgkin lymphoma (HL) patients are older than 50 years at diagnosis, a fact which is not commonly recognized. Older patients do significantly worse than younger patients and are rarely included in clinical trials. METHODS: Using data from Swedish Cancer and Lymphoma Registries, we estimated relative survival ratios (RSRs) for 7997 HL patients (diagnosed 1973-2013; 45% ≥50 years). RESULTS: The 1-year RSRs (95% confidence interval; CI) for males aged 45-59, 60-69, 70-80, and 81 years and over, diagnosed in 2013, were 0.95 (0.91-0.97), 0.88 (0.81-0.92), 0.74 (0.63-0.81), and 0.52 (0.35-0.67), respectively. The corresponding 1-year RSRs for females were 0.97 (0.94-0.98), 0.91 (0.85-0.95), 0.82 (0.73-0.88), and 0.66 (0.50-0.77). No improvements in 1-year of 5-year relative survival from 2000 to 2013 were observed for patients aged 45-59 or 60-69 but there were modest improvements for patients aged 70 years and older. Importantly, we saw no changes in the distribution of disease or patient characteristics between 2000 and 2013. CONCLUSIONS: Elderly patients constitute a large group with clearly unmet medical needs. Our findings motivate a more active approach to including elderly patients in clinical trials. Our study provides a baseline for outcome comparison after the broader introduction of targeted drugs.
Authors: Björn Engelbrekt Wahlin; Ninja Övergaard; Stefan Peterson; Evangelos Digkas; Ingrid Glimelius; Ingemar Lagerlöf; Ann-Sofie Johansson; Marzia Palma; Lotta Hansson; Johan Linderoth; Christina Goldkuhl; Daniel Molin Journal: EJHaem Date: 2021-05-06
Authors: Tove Wästerlid; Kim Oren Gradel; Sandra Eloranta; Ingrid Glimelius; Tarec C El-Galaly; Henrik Frederiksen; Karin E Smedby Journal: Br J Haematol Date: 2020-11-24 Impact factor: 6.998
Authors: Maxine Je Lamb; Eve Roman; Debra A Howell; Eleanor Kane; Timothy Bagguley; Cathy Burton; Russell Patmore; Alexandra G Smith Journal: BJGP Open Date: 2019-12-10