Boell, Boris, Goergen, Helen, Arndt, Nils, Meissner, Julia, Krause, Stefan W., Schnell, Roland, von Tresckow, Bastian, Eichenauer, Dennis A., Sasse, Stephanie, Fuchs, Michael, Behringer, Karalin, Klimm, Beate C., Naumann, Ralph, Diehl, Volker, Engert, Andreas and Borchmann, Peter (2013). Relapsed Hodgkin Lymphoma in Older Patients: A Comprehensive Analysis From the German Hodgkin Study Group. J. Clin. Oncol., 31 (35). S. 4431 - 4442. ALEXANDRIA: AMER SOC CLINICAL ONCOLOGY. ISSN 1527-7755

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Abstract

Purpose Progression or relapse of Hodgkin lymphoma (HL) is common among older patients. However, prognosis and effects of second-line treatment are thus far unknown. Patients and Methods We investigated second-line treatment and survival in older patients with progressive or relapsed HL. Patients treated within German Hodgkin Study Group first-line studies between 1993 and 2007 were screened for refractory disease or relapse (RR-HL). Patients with RR-HL age 60 years at first-line treatment were included in this analysis. Results We identified 105 patients (median age, 66 years); 28%, 31%, and 41% had progressive disease, early relapse, or late relapse, respectively. Second-line treatment strategies included intensified salvage regimens (22%), conventional polychemotherapy and/or salvage-radiotherapy with curative intent (42%), and palliative approaches (31%). Median overall survival (OS) for the entire cohort was 12 months; OS at 3 years was 31% (95% CI, 22% to 40%). A prognostic score with risk factors (RFs) of early relapse, clinical stage III/IV, and anemia identified patients with favorable and unfavorable prognosis ( one RF: 3-year OS, 59%; 95% CI, 44% to 74%; two RFs: 3-year OS, 9%; 95% CI, 1% to 18%). In low-risk patients, the impact of therapy on survival was significant in favor of the conventional polychemotherapy/salvage radiotherapy approach. In high-risk patients, OS was low overall and did not differ significantly among treatment strategies. Conclusion OS in older patients with RR-HL can be predicted using a simple prognostic score. Poor outcome in high-risk patients cannot be overcome by any of the applied treatment strategies. Our results might help to guide treatment decisions and evaluate new compounds in these patients.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Boell, BorisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goergen, HelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arndt, NilsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meissner, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krause, Stefan W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schnell, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Tresckow, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eichenauer, Dennis A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sasse, StephanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuchs, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Behringer, KaralinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klimm, Beate C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Naumann, RalphUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diehl, VolkerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engert, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borchmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-470202
DOI: 10.1200/JCO.2013.49.8246
Journal or Publication Title: J. Clin. Oncol.
Volume: 31
Number: 35
Page Range: S. 4431 - 4442
Date: 2013
Publisher: AMER SOC CLINICAL ONCOLOGY
Place of Publication: ALEXANDRIA
ISSN: 1527-7755
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
HEMATOPOIETIC-CELL TRANSPLANTATION; INVOLVED-FIELD RADIOTHERAPY; HIGH-DOSE CHEMOTHERAPY; STUDY-GROUP GHSG; AGED 60 YEARS; ELDERLY-PATIENTS; BRENTUXIMAB VEDOTIN; RANDOMIZED-TRIAL; INTENSITY; DISEASEMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/47020

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