Outcome of elderly patients with classical Hodgkin’s lymphoma

Šýkorová, Alice; Móciková, Heidi; Lukásová, M; Kořen, Jan; Štěpánková, Pavla; Procházka, Vít; Belada, David; Klásková, Kateřina; Gaherova, Lubica; Chroust, K.; Burešová, Lucie; Marková, Jana

doi:10.1016/j.leukres.2020.106311

Cited by 9 publications

(18 citation statements)

References 36 publications

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“…It has been reported that cHL is more common in males in all age groups, 11 including the elderly population. 4 , 5 , 7 Most of our patients were also male; however, the percentage of female patients (51%) was slightly high in patients ≥60 years of age. Most probably this was due to the fact that 55.8% of the elderly population in our country is female.…”

Section: Discussionmentioning

confidence: 65%

“…While the 5-year overall survival (OS) of patients with cHL is 86.6%, this is 57.5% in patients aged ≥60 years. 4–6 The inferior prognosis in elderly cHL is multifactorial. Diagnosis in advanced disease stage, aggressive course of the disease, Epstein–Barr virus (EBV) associated disease, B symptoms, poor performance status, comorbidities are more common in elderly patients than in younger patients.…”

Section: Introductionmentioning

confidence: 99%

“…In the elderly patient group, the tolerance of conventional therapy decreases and there is more treatment toxicity with more treatment-related deaths. 4 , 5 , 7 …”

Section: Introductionmentioning

confidence: 99%

“… 7 , 8 The optimal management of unfit elderly patients is still unclear. Eastern Cooperative Oncology Group performance status (ECOG PS), 4 Cumulative Disease Rating Score (CIRS), 9 Adult Comorbidity Evaluation-27 (ACE-27), 10 and Comprehensive Geriatric Evaluation (CGA) 4 are some of the comorbidity and PS indices that might guide individual treatment selection.…”

Section: Introductionmentioning

confidence: 99%

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Treatment Responses, Toxicity, and Survival in Patients with Classical Hodgkin Lymphoma Aged ≥50 Years: A Single-Center Experience Over Two Decades

Çokgezer¹,

Elverdi²,

Salihoğlu³

et al. 2022

CMAR

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Introduction The aim of this study was to evaluate treatment responses, toxicity, and survival among cHL patients aged ≥50 years. Methods We retrospectively identified all newly diagnosed cHL patients and only included cases who were ≥50 years old at the time of diagnosis and with data available between 1999 and 2020. Results There were 101 patients, of which 52 were between 50 and 59 years of age, and 49 patients were ≥60 years old. Sixty-two patients were male, and the most common histopathological subtype was mixed cellularity cHL (58.4%). ECOG PS, CCI, CIRS, and ACE-27 scores were significantly higher in patients aged ≥60 years than those of 50–59 age group. While all patients aged 50–59 years received ABVD as first-line therapy, 79% (n=39) of cases aged ≥60 years had ABVD. In patients receiving ABVD, 95% and 92.7% of the cases aged 50–59 and ≥60 years had CR, respectively ( p =0.999). Age groups were comparable in terms of hematological and non-hematological toxicities ( p =0.369, p =0.127, respectively). Although not statistically significant, median survival was longer in patients receiving a transplant than in those without transplantation (108 months vs 52 months, p =0.069). In multivariate analysis, the risk of progression was higher in patients with lymphocyte ≤600/mm 3 and in those who were unresponsive to first-line therapy ( p =0.002 and p <0.001, respectively). Patients with B symptoms, age ≥60 years, and CIRS >3 had higher risk of mortality ( p =0.001, p =0.012, p =0.038, respectively). By using these 3 parameters, we defined a new risk score, which divided our patient cohort into two as low- and high-risk groups. Low-risk patients had significantly higher survival rates than the high-risk group (83.9% vs 40.5%, p <0.001). Discussion This new prognostic score should be further tested and validated in other patient populations. Although our study has some limitations including the limited number of patients and its retrospective nature, there are not so many studies in elderly cHL patients and elderly and/or frail patients are generally excluded in most of the clinical trials. Thus, this real-life single-center experience would contribute to the literature.

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Section: Discussionmentioning

confidence: 65%

Section: Introductionmentioning

confidence: 99%

“…In the elderly patient group, the tolerance of conventional therapy decreases and there is more treatment toxicity with more treatment-related deaths. 4 , 5 , 7 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment Responses, Toxicity, and Survival in Patients with Classical Hodgkin Lymphoma Aged ≥50 Years: A Single-Center Experience Over Two Decades

Çokgezer¹,

Elverdi²,

Salihoğlu³

et al. 2022

CMAR

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“…34 In younger age groups traditional approaches using chemotherapy, and radiotherapy in selected patients, produce high rates of long-term remission; however, the disease remains more challenging in older patients. 85 Epigenetic changes are clearly important in the pathogenesis of HL, 10 and in vitro activity of HDIs has been demonstrated, 44 but relatively few studies have reported efficacy outcomes. Table II 9,26,39,47,97,99 summarises selected published studies.…”

Section: Hodgkin Lymphomamentioning

confidence: 99%

Epigenetic targeting in lymphoma

Booth

Collins

2020

Br J Haematol

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Despite considerable progress in the treatment of patients with lymphoid malignancies in recent decades, the prognosis of patients with relapsed or refractory lymphomas often remains disappointing. Increasing evidence has established the relevance of epigenetic alterations in the pathogenesis of lymphoid malignancies, and a succession of agents has been evaluated in clinical studies with varying efficacy. In the present review, we outline the importance of epigenetic modifications in lymphoma biology and discuss the published experience with epigenetic modifying agents by lymphoma subtype before considering ongoing clinical studies in this area.

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Antineoplastics

2020

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Outcome of elderly patients with classical Hodgkin’s lymphoma

Cited by 9 publications

References 36 publications

Treatment Responses, Toxicity, and Survival in Patients with Classical Hodgkin Lymphoma Aged ≥50 Years: A Single-Center Experience Over Two Decades

Treatment Responses, Toxicity, and Survival in Patients with Classical Hodgkin Lymphoma Aged ≥50 Years: A Single-Center Experience Over Two Decades

Epigenetic targeting in lymphoma

Antineoplastics

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