A single-center retrospective cohort analysis revealed real-world insights into possible treatments for elderly patients with Hodgkin lymphoma. The findings were published in Hematology Oncology.
The cohort included 34 elderly patients between 2009 and 2018 who had Hodgkin lymphoma. The results of a geriatric assessment informed treatment choice. Fit or unfit patients 70 years or younger received adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD); unfit patients received vinblastine, cyclophosphamide, procarbazine, etoposide, mitoxantrone, and bleomycin (VEPEMB); frail patients received chlorambucil, vinblastine, procarbazine, and prednisone (ChlVPP); and 1 patient with HIV received brentuximab vedotin (BV). Radiotherapy was used as consolidation therapy as needed.
Of the 34 patients, 29 achieved responses (85%), which included 25 (74%) complete responses (CRs) and 4 (12%) partial responses. Of the 13 early-stage patients, 12 (92%) achieved a CR, whereas among the 21 advanced-stage patients, 13 (62%) achieved a CR.
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Overall, 12 patients (35%) had grade 3/4 neutropenia and 9 patients (26%) had complications from infection; the rates of neutropenia and complications from infections were similar for ABVD compared with other treatment regimens. No treatment-related deaths were reported.
At 3 years of follow-up, an estimated 62% of patients remain disease free and 73% remain alive. Being older than 70 years, having advanced-stage disease, and being considered unfit or frail were correlated with a shorter progression-free survival.
The study authors suggest ABVD could be a “useful option” with “curative intent” for fit patients aged younger than 70 years. They also suggest that patients older than 70 years of age or with significant comorbidities should receive “less intensive” regimens such as VEPEMB or ChlVPP.
Reference
Cencini E, Fabbri A, Sicuranza A, Santoni A, and Bocchia M. Hodgkin lymphoma in the elderly: New perspectives and a 10-year monocenter real-life experience [published online September 2, 2019]. Hematol Oncol. doi: 10.1002/hon.2675
