Background. The proportion of elderly Hodgkin lymphoma (HL) patients (age ≥ 60 years) ranges between 15% and 35%. Outcome of this group of patients (pts) is significantly inferior compared with younger pts. Management of therapy is still unclear, standard treatment is not yet defined. Purpose of this study was to analyze treatment and outcome of elderly HL pts prospectively registered in Hodgkin Lymphoma Project in the Czech Republic. Patients and methods. The proportion of elderly patients in the Czech HL Registry was 11%. We analyzed 151 pts ≥ 60 years with classical HL (pts with nodular lymphocyte predominant HL were excluded) diagnosed between 2000 and 2016. Median age was 67 (60-83) years, 68.9% of them were 60-69 years old and male gender represented 55% (83 pts). Histological subtype mixed cellularity occured in 55%. Advanced clinical stage (CS) was confirmed in 60.9%. Chemotherapy (CT) alone was used in 66.2% of pts (initial/intermediate CS 23 pts, advanced CS 76 pts). Combined modality of treatment (CT and radiotherapy, RT) was used in 40 pts (intial/intermediate CS 27 pts, advanced CS 13 pts). Anthracycline – based CT received 79.4 % of pts (86 pts). Five pts (4%) were treated with RT alone, three pts received supportive care only and treatment in three pts was not reported to the Registry. Results. Overall response rate after the first-line treatment was observed in 70.9% (57.6% CR), SD in 0.7% and primary disease progression in 7.3% of pts. Treatment response was not evaluable in 21.2% of pts. Relapses occured in 12.6% (19 pts) and 3 pts underwent high dose CT and autologous stem cell transplantation (age 61, 63, 64 years). Median PFS and OS was 7.9 years (y) and 10.2y, respectively. Two – year PFS and OS was 73.1% and 81.5%, respectively. Overall 53.6% pts are alive and 31.8% (48 pts) of pts died: HL progression 11 pts, toxicity of treatment 14 pts, others causes 13 pts. Conclusions. Outcome of our retrospectively analyzed pts with classical HL compares favorably with other reported data in the group of elderly pts. Long-term survival of our pts depended on te use of anthracycline-containing CT. Prospective clinical studies are still needed to determine an optimal effective regimen with low toxicity in elderly pts.
This work was supported by grant awarded by AZV 16-29857A, Ministry of Health in Czech Republic and Research project P 27/2012 awarded by Charles University in Prague, Third Faculty of Medicine, Prague, Czech Republic