Department of Medicine, Division of Hematology, Karolinska University Hospital Solna and Karolinska Institutet, Stockholm, Sweden.
Blood. 2012 Jan 26;119(4):990-6. doi: 10.1182/blood-2010-08-302604. Epub 2011 Dec 6.
In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N = 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009). Relative survival improved in all age groups, with the greatest improvement in patients 51-65 years of age (P < .0005). A plateau in relative survival was observed in patients below 65 years of age during the last calendar period, suggesting a reduced long-term, treatment-related mortality. The 10-year relative survival for patients diagnosed in 2000-2009 was 0.95, 0.96, 0.93, 0.80, and 0.44 for the age groups 0-18, 19-35, 36-50, 51-65, and 66-80, respectively. Therefore, despite progress, age at diagnosis remains an important prognostic factor (P < .0005). Advances in therapy for patients with limited and advanced-stage HL have contributed to an increasing cure rate. In addition, our findings support that long-term mortality of HL therapy has decreased. Elderly HL patients still do poorly, and targeted treatment options associated with fewer side effects will advance the clinical HL field.
近几十年来,人们一直关注降低霍奇金淋巴瘤(HL)的长期治疗相关发病率和死亡率。在本研究中,我们研究了瑞典从 1973 年至 2009 年所有被诊断为 HL 的患者的相对生存率趋势(N = 6949;3985 名男性和 2964 名女性;中位年龄为 45 岁),并随访至 2010 年底死亡。患者分为 6 个年龄组和 5 个日历期(1973-1979 年、1980-1986 年、1987-1994 年、1994-2000 年和 2001-2009 年)。所有年龄组的相对生存率均有所提高,51-65 岁患者的提高最为显著(P <.0005)。在最后一个日历期,65 岁以下患者的相对生存率趋于平稳,这表明治疗相关的长期死亡率降低。2000-2009 年诊断的患者 10 年相对生存率分别为 0.95、0.96、0.93、0.80 和 0.44,相应年龄组为 0-18 岁、19-35 岁、36-50 岁、51-65 岁和 66-80 岁。因此,尽管取得了进展,诊断时的年龄仍然是一个重要的预后因素(P <.0005)。局限期和晚期 HL 患者治疗的进展,使治愈率不断提高。此外,我们的研究结果表明 HL 治疗的长期死亡率有所降低。老年 HL 患者的预后仍然较差,具有较少副作用的靶向治疗选择将推动 HL 临床领域的发展。