Hodgkin lymphoma (HL) affects an appreciable number of older patients, which is most commonly defined as age ≥60 years. It accounts for approximately 10-20% of HL patients. This study assessed the clinical characteristics, treatment strategies, and evolution of this category of patients.
Patients and methods:
This is a retrospective descriptive study based on medical records and follow-up sheets of patients >60 y who were treated and monitored for Hodgkin lymphoma at the Casablanca clinical hematology department between 01-2015 and 12- 2020.
Over a 5-year period, 26 patients were collected, accounting for 13%. The median age was 67 years old, and the gender ratio was 1.36. The average time between diagnosis and treatment was 11 months. Smoking (7 patients), heart disease (2 patients), hypertension (3 patients), diabetes (1 patient), and tuberculosis infection (1 patient) were among the morbidities discovered. Lymph node involvement was found in 73% of the cases. B signs were present in 53% of the patients. In 70% of cases, the performance status was 1, and the tumor was bulky in 53% of cases. The disease is advanced in 60% of patients (stages III-IV). The histological type was scleronodular in 84%. Except for 1 patient who died before receiving treatment, all of the 25 patients who were followed up on received chemotherapy, ABVD/Radiotherapy (4 patients), ABVD alone (19 patients), AVD (2 patients). ABVD was given in 3 to 8 cycles. 5 patients (20%) experienced hematological toxicity, with one case necessitating a complete cessation of chemotherapy; 1 patient (4%) died from renal failure and pulmonary embolism; one patient experienced bleomycin toxicity (4 %). Complete remission was achieved in 76% of cases, 8% of patients experienced therapeutic failure, 12% died, and 8% were lost to follow-up. Alter 5 years, the overall survival (OS) and progression-free survival (PFS) were 88% and 72% respectively.
As with other types of malignant pathologies, treating an elderly patient with HL necessitates a comprehensive approach that includes an assessment of comorbidities to balance the risk/benefit ratio.
HL; Hodgkin lymphoma; elderly.