A retrospective multicenter analysis of elderly Hodgkin lymphoma: outcomes and prognostic factors in the modern era

Author:

Evens Andrew M.1,Helenowski Irene2,Ramsdale Erika3,Nabhan Chadi4,Karmali Reem5,Hanson Britt6,Parsons Benjamin4,Smith Scott6,Larsen Annette1,McKoy June M.7,Jovanovic Borko2,Gregory Stephanie6,Gordon Leo I.8,Smith Sonali M.3

Affiliation:

1. Division of Hematology/Oncology, University of Massachusetts Medical School, Worcester, MA;

2. Department of Preventive Medicine, Northwestern University, Chicago, IL;

3. Department of Medicine, Division of Hematology/Oncology, University of Chicago Hospitals, Chicago, IL;

4. Department of Medicine, Division of Hematology/Oncology, Advocate Lutheran General Hospital, Park Ridge, IL;

5. Division of Hematology, Rush University Medical Center, Chicago, IL;

6. Division of Hematology/Oncology, Loyola University Medical Center, Maywood, IL;

7. Division of Geriatric Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL; and

8. Division of Hematology/Oncology, Northwestern University, Chicago, IL

Abstract

AbstractWe investigated a recent (January 1999 to December 2009) cohort of 95 elderly Hodgkin lymphoma subjects. At diagnosis, median age was 67 years (range, 60-89 years), whereas 61% had significant comorbidity, 26% were unfit, 17% had a geriatric syndrome, and 13% had loss of activities of daily living. Overall response rate to therapy was 85%, whereas incidence of bleomycin lung toxicity was 32% (with associated mortality rate, 25%). With 66-month median follow-up, 2-year and 5-year overall survival were 73% and 58%, respectively (advanced-stage, 63% and 46%, respectively). Most International Prognostic Score factors were not prognostic on univariate analyses, whereas Cox multivariate regression identified 2 risk factors associated with inferior overall survival: (1) age more than 70 years (2.24; 95% CI, 1.16-4.33, P = .02) and (2) loss of activities of daily living (2.71; 95% CI, 1.07-6.84, P = .04). Furthermore, a novel survival model based on number of these risk factors (0, 1, or 2) showed differential 2-year OS of 83%, 70%, and 13%, respectively (P < .0001) and 5-year OS of 73%, 51%, and 0%, respectively (P < .0001).

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference27 articles.

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