Clinical characteristics and outcome of patients over 60 years with Hodgkin lymphoma treated in Switzerland.

Autor: Moccia AA; Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland., Aeppli S; Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland., Güsewell S; Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland., Bargetzi M; Hematology, Kantonsspital Aarau, Aarau, Switzerland., Caspar C; Medical Oncology and Hematology, Kantonsspital Baden, Baden, Switzerland., Brülisauer D; Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland., Ebnöther M; Medical Oncology and Hematology, Claraspital, Basel, Switzerland., Fehr M; Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland., Fischer N; Medical Oncology and Hematology Clinic, Kantonsspital Winterthur, Winterthur, Switzerland., Ghilardi G; Hematology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland., Krasniqi F; Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland., Lang N; Medical Oncology Clinic, University Hospital of Geneva, Genève, Switzerland., Mey U; Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland., Mingrone W; Medical Oncology Clinic, Kantonsspital Olten, Olten, Switzerland., Novak U; Medical Oncology Clinic, Inselspital, University Hospital of Bern, Bern, Switzerland., Pfleger C; Medical Oncology and Hematology, Claraspital, Basel, Switzerland., Richter P; Medical Oncology and Hematology, Kantonsspital Graubünden, Chur, Switzerland., Rütti M; Internal Medicine Clinic, Spital Wil, Wil, Switzerland., Schmidt A; Medical Oncology and Hematology Clinic, Stadtspital Triemli, Zürich, Switzerland., Stenner F; Medical Oncology Clinic, University Hospital of Basel, Basel, Switzerland., Voegeli M; Medical Oncology and Hematology Clinic, Kantonsspital Baselland, Liestal, Switzerland., Zander T; Medical Oncology, Luzerner Kantonsspital, Luzern, Switzerland., Zucca E; Medical Oncology Clinic, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland., Hitz F; Medical Oncology and Hematology Clinic, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Jazyk: angličtina
Zdroj: Hematological oncology [Hematol Oncol] 2021 Apr; Vol. 39 (2), pp. 196-204. Date of Electronic Publication: 2020 Dec 23.
DOI: 10.1002/hon.2830
Abstrakt: Hodgkin lymphoma (HL) in older patients appears to be a different disease compared with younger patients with historically lower survival rates. This is related to a variety of factors, including increased treatment-related toxicity, the presence of comorbidities, and biologic differences. In order to better assess the clinical characteristics, treatment strategies, and outcome of this particular population, we conducted a population-based, retrospective analysis including 269 patients with HL older than 60 years (median age 71 years, range 60-94), treated between 2000 and 2017 in 15 referral centers across Switzerland. Primary endpoints were overall survival (OS), progression-free survival (PFS), and cause-specific survival (CSS). The vast majority of patients were treated with curative intent, either with a combined modality approach (chemotherapy followed by radiation therapy) or with systemic therapy. At a median follow-up of 6.6 years (95% confidence interval [CI], 6.0-7.6), 5-year PFS was 52.2% (95% CI, 46.0-59.2), 5-year OS was 62.5% (95% CI, 56.4-69.2), and 5-year CSS was 85.1.8% (95% CI, 80.3-90.1) for the entire cohort. A significant difference in terms of CSS was observed for patients older than 71 years in comparison to patients aged 60-70 years (hazard ratio 2.6, 1.3-5.0, p = 0.005). Bleomycin-induced lung toxicity (BLT) was documented in 26 patients (17.7%) out of the 147 patients exposed to this compound and was more frequent in patients older than 71 years (15/60, 25%). Outcome of HL pts older than 71 years appeared to decrease substantially in comparison to the younger counterpart. Treatment-related toxicities appeared to be relevant, in particular, BLT. New, potentially less toxic strategies need to be investigated in prospective clinical trials in this particular frail population.
(© 2020 John Wiley & Sons Ltd.)
Databáze: MEDLINE