Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO Subscriptions PDA Services My JCO Customer Service

Originally published as JCO Early Release 10.1200/JCO.2005.11.080 on June 13 2005

Journal of Clinical Oncology, Vol 23, No 22 (August 1), 2005: pp. 5052-5060
© 2005 American Society of Clinical Oncology.

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Engert, A.
Right arrow Articles by Diehl, V.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Engert, A.
Right arrow Articles by Diehl, V.

Hodgkin's Lymphoma in Elderly Patients: A Comprehensive Retrospective Analysis From the German Hodgkin's Study Group

Andreas Engert, Veronika Ballova, Heinz Haverkamp, Beate Pfistner, Andreas Josting, Eckhart Dühmke, Konrad Müller-Hermelink, Volker Diehl

From the Department I of Internal Medicine, University of Cologne; German Hodgkin Study Group, University of Cologne, Cologne; Department of Radiation Oncology, Ludwig Maximilian Universität München, Munich; and Department of Pathology, University Hospital of Würzburg, Germany

Address reprint requests to Andreas Engert, MD, Department of Internal Medicine I, University Hospital of Cologne, Kerpener Str 62, 50924 Cologne, Germany; e-mail: a.engert{at}uni-koeln.de

PURPOSE: With improved prognosis for patients with Hodgkin's lymphoma (HL), interest increasingly focuses on high-risk groups such as elderly patients. We thus performed a retrospective analysis using the German Hodgkin's Study Group (GHSG) database to determine clinical risk factors, course of treatment, and outcome in elderly HL patients in comparison with younger adults.

PATIENTS AND METHODS: A total of 4,251 patients included in the GHSG studies HD5 to HD9 were analyzed, of whom 372 (8.8%) were 60 years or older and 3,879 (91.2%) were younger than 60 years. Patient characteristics, treatment results, toxicity, freedom from treatment failure (FFTF), and overall survival (OS) were compared.

RESULTS: Elderly patients more often had mixed cellularity subtype, "B" symptoms, elevated erythrocyte sedimentation rate, and poorer performance status. Less frequently observed were nodular sclerosis subtype, large mediastinal mass, and bulky disease. Acute toxicity during chemotherapy was generally higher in elderly patients. This was most obvious for severe infections (grade 3 or 4; 15% v 6%) correlating with more severe leukopenia in elderly patients (grade 4; 38% v 23%). As a result, significantly fewer elderly patients received the intended full chemotherapy dose (75% v 91%). The survival analysis showed a significantly poorer treatment outcome for elderly patients in terms of 5-year OS (65% v 90%), FFTF (60% v 80%), and HL-specific FFTF (73% v 82%).

CONCLUSION: Elderly patients have a poorer risk profile compared with younger HL patients and experience more severe treatment-associated toxicity. Higher mortality during treatment as well as lower dose-intensity are the major factors explaining the poorer overall outcome of elderly HL patients.

Supported by The German Hodgkin's Study Group, which is supported by the Deutsche Krebshilfe and is part of the Kompetenznetz Maligne Lymphome, which is supported by the Bohdesministerium für Bilding und Forschung.

Authors' disclosures of potential conflicts of interest are found at the end of this article.




This article has been cited by other articles:


Home page
BloodHome page
H. Brenner, A. Gondos, and D. Pulte
Ongoing improvement in long-term survival of patients with Hodgkin disease at all ages and recent catch-up of older patients
Blood, March 15, 2008; 111(6): 2977 - 2983.
[Abstract] [Full Text] [PDF]


Home page
Ann OncolHome page
B Klimm, H. Eich, H Haverkamp, A Lohri, P Koch, F Boissevain, G Trenn, P Worst, E Duhmke, R. Muller, et al.
Poorer outcome of elderly patients treated with extended-field radiotherapy compared with involved-field radiotherapy after chemotherapy for Hodgkin's lymphoma: an analysis from the German Hodgkin Study Group
Ann. Onc., February 1, 2007; 18(2): 357 - 363.
[Abstract] [Full Text] [PDF]


Home page
ASH Education BookHome page
S. J. Horning
Risk, Cure and Complications in Advanced Hodgkin Disease
Hematology, January 1, 2007; 2007(1): 197 - 203.
[Abstract] [Full Text] [PDF]


Home page
Ann OncolHome page
O. Landgren, U. Axdorph, T. R. Fears, A. Porwit-MacDonald, C. Wedelin, and M. Bjorkholm
A population-based cohort study on early-stage Hodgkin lymphoma treated with radiotherapy alone: with special reference to older patients
Ann. Onc., August 1, 2006; 17(8): 1290 - 1295.
[Abstract] [Full Text] [PDF]



About
JCO
 Editorial
Roster
 Advertising
Information
 Librarians &
Institutions
 Rights &
Permissions
 Site Map

Copyright © 2005 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online