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. 2022 Nov 22;6(22):5924-5932.
doi: 10.1182/bloodadvances.2022008258.

The outcome of older adults with classic Hodgkin lymphoma in British Columbia

Phoebe T M Cheng  1 , Diego Villa  1 , Alina S Gerrie  1 , Ciara L Freeman  2 , Graham W Slack  3 , Randy D Gascoyne  3 , Pedro Farinha  3 , Jeffrey W Craig  3 , Brian Skinnider  3 , Don Wilson  4 , David W Scott  1 , Joseph M Connors  1 , Laurie H Sehn  1 , Kerry J Savage  1
Affiliations

The outcome of older adults with classic Hodgkin lymphoma in British Columbia

Phoebe T M Cheng et al. Blood Adv. .

Abstract

Outcomes in older adults with classic Hodgkin lymphoma (cHL) have traditionally been poor, in part, related to poor tolerance to standard chemotherapy. Herein, we evaluated the survival of patients with cHL aged ≥60 years in British Columbia in a population-based analysis. From 1961 to 2019, 744 patients with newly diagnosed cHL were identified. With a median follow-up of 9 years, 5-year disease-specific survival (DSS) and overall survival (OS) have improved by decade comparison (both P < .001), remaining stable in the past 20 years (DSS, P = .35; OS, P = .26). In the modern management era (2000-present), 361 of 401 patients (90%) received active therapy for cHL and had a 5-year OS of 60%. For those who received curative-intent therapy (n = 327), the 5-year progression-free survival (PFS), OS, and DSS were 60%, 65%, and 76%, respectively, and estimates were superior in those who were 60 to 69 years of age (72%, 77%, and 83%, respectively) compared with those who were 70 to 79 years of age (54%, 57%, and 70%, respectively) and ≥80 years of age (28%, 39%, and 63%, respectively) (P < .05 for all). Overall, pulmonary toxicity occurred in 58 of 279 patients (21%) treated with bleomycin, with 22 of 58 (38%) occurring after cycles 1 or 2, accounting for 8 of 20 (40%) treatment-related deaths. Outcomes in older adults with cHL have improved in recent decades; however, they remain poor for those aged ≥70 years, even in the modern treatment era. Furthermore, treatment-related toxicity remains a significant concern and use of bleomycin should be avoided in most patients.

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Conflict of interest statement

Conflict-of-interest disclosure: D.V. received honoraria from/consults for BMS/Celgene, Kite/Gilead, Merck, Kyowa Kirin, Janssen, AstraZeneca, AbbVie, and Roche. A.S.G. received honoraria from/consults for AstraZeneca, AbbVie, Janssen, Celgene, and Sandoz; received research funding from AstraZeneca, AbbVie, and Janssen; and research funding (to the institution) from Roche and AstraZeneca. C.L.F received honoraria from/consults for BMS, Seattle Genetics, Celgene, AbbVie, Sanofi, Incyte, Amgen, and Janssen; and research funding from Teva, Janssen, and Roche/Genentech. J.W.C. consults for Bayer. G.W.S. received honoraria from/consults for Seattle Genetics. L.H.S. received research funding from F. Hoffmann-La Roche Ltd, and Genentech Inc; and received honoraria from/consults for F. Hoffmann-La Roche Ltd, Genentech Inc, AbbVie, Amgen, Apobiologix, Acerta, AstraZeneca, Celgene, Gilead, Janssen, Kite Pharma, Karyopharm, Lundbeck, Merck, MorphoSys, Seattle Genetics, Takeda, Teva, TG Therapeutics, Verastem, and Incyte. K.J.S. received honoraria from/consults for Seattle Genetics, BMS, Merck, Kyowa, Janssen, Novartis, and Incyte; serves on the steering committee of BeiGene; received research funding from Roche and BMS; and serves on the Data and Safety Monitoring Committee of Regeneron. The remaining authors declare no competing financial interests.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Historical outcomes in older adults with cHL from 1960 to 2019. (A) DSS; (B) OS.
Figure 2.
Figure 2.
Outcome of older adults with cHL in the modern-era curative cohort by age group. (A) PFS; (B) OS; and (C) DSS.
See this image and copyright information in PMC

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