Treatment patterns and outcomes for Hodgkin Lymphoma patients aged 60 and older: a report from the Brazilian Prospective Hodgkin Lymphoma Registry

The treatment of older patients with Hodgkin lymphoma (HL) remains a challenge. We sought to identify the treatment patterns and outcomes in older HL patients included in the Brazilian HL registry (NCT02589548). A total of 136 patients with HIV-negative classic HL, aged ≥ 60 years, diagnosed between...

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Detalles Bibliográficos
Autores: Goveia, Lilian, Castro, Nelson, de Souza, Carmino, Colaço Villarim, Carolina, Traina, Fabiola, Chiattone, Carlos Sergio, Praxedes, Monica, Solza, Cristiana, Perobelli, Leila, Baiocchi, Otavio, Gaiolla, Rafael [UNESP], Boquimpani, Carla, Buccheri, Valeria, Bonamin Sola, Caroline, de Oliveira Paula e Silva, Roberta, Ribas, Ana Carolina, Steffenello, Giovanna, Pagnano, Katia, Soares, Andrea, Souza Medina, Samuel, Silveira, Talita, Zattar Cecyn, Karin, Carvalho Palma, Leonardo, de Oliveira Marques, Mariana, Spector, Nelson, Biasoli, Irene
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:Brasil
Institución:Universidade Estadual Paulista (UNESP)
Repositorio:Repositório Institucional da UNESP
Idioma:inglés
OAI Identifier:oai:repositorio.unesp.br:11449/303563
Acceso en línea:http://dx.doi.org/10.1007/s00277-023-05352-w
https://hdl.handle.net/11449/303563
Access Level:acceso abierto
Palabra clave:Hodgkin lymphoma
older patients
socioeconomic status
treatment outcomes
Descripción
Sumario:The treatment of older patients with Hodgkin lymphoma (HL) remains a challenge. We sought to identify the treatment patterns and outcomes in older HL patients included in the Brazilian HL registry (NCT02589548). A total of 136 patients with HIV-negative classic HL, aged ≥ 60 years, diagnosed between 2009 and 2018, were analyzed. The median age was 66 years old (60-90), 72% had advanced disease, 62% had a high IPS, and 49% had a nodular sclerosis subtype. Median follow-up was 64 months for alive patients. ABVD was the front-line treatment in 96% of patients. Twenty-one patients (15%) died during front-line treatment. The 5-year PFS and 5-year OS rates were 55% and 59%, respectively. The 5-year OS rates in localized and advanced disease were 81% and 51% (p=0.013). Lung toxicity developed in 11% of the patients treated with ABVD. Bleomycin was administered for > 2 cycles in 65% of patients. Compared with 2009-2014, there was a decrease in the use of bleomycin for > 2 cycles in 2015-2018 (88% × 45%, p<0.0001). The impact of socioeconomic status (SES) on outcomes was studied in patients treated with ABVD. After adjusting for potential confounders, lower SES remained independently associated with poorer survival (HR 2.22 [1.14-4.31] for OS and HR 2.84 [1.48-5.45] for PFS). Treatment outcomes were inferior to those observed in developed countries. These inferior outcomes were due to an excess of deaths during front-line treatment and the excessive use of bleomycin. SES was an independent factor for shorter survival.

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