a Department of Medicine , Internal Medicine Residency Training Program, University of Colorado School of Medicine , Aurora , CO , USA.
b Department of Radiation Oncology , University of Colorado School of Medicine , Aurora , CO , USA.
Leuk Lymphoma. 2019 May;60(5):1234-1243. doi: 10.1080/10428194.2018.1522435. Epub 2018 Dec 3.
Elderly patients with classical Hodgkin lymphoma (cHL) are understudied and poorly defined. The National Cancer Data Base was queried for adults with cHL diagnosed 2004-2013: 22,547 age 18-39, 12,841 age 40-59, and 10,873 age ≥60 were identified. Two-year overall survival (OS) was 97%, 91%, and 65% for the three age cohorts, respectively (p < .0001). Elderly patients age ≥60 had greater advanced comorbidity scores, stage III-IV disease, and lymphocyte-depleted histology. Elderly patients were treated less with chemotherapy, radiotherapy for stage I-II disease, and at academic/research centers (p < .001). There was improved OS in elderly patients who received chemotherapy and/or radiotherapy and were treated at academic/research centers. This largest analysis of elderly cHL demonstrates that patients ≥60 are distinct from those 40-59. Age ≥60 should be a stratification in future trials and merit distinct studies. Improving the poor rate of treatment delivery and directing care to academic centers may improve outcomes.
老年经典霍奇金淋巴瘤（cHL）患者研究较少且定义不明确。本研究分析了 2004 年至 2013 年间诊断为 cHL 的成年人的国家癌症数据库：年龄 18-39 岁的有 22547 例，年龄 40-59 岁的有 12841 例，年龄≥60 岁的有 10873 例。三组患者的 2 年总生存率（OS）分别为 97%、91%和 65%（p<0.0001）。年龄≥60 岁的老年患者合并症评分较高、III-IV 期疾病和淋巴细胞耗竭型组织学比例较高。与年轻患者相比，老年患者接受化疗、I-II 期疾病放疗和在学术/研究中心治疗的比例较低（p<0.001）。在接受化疗和/或放疗且在学术/研究中心治疗的老年患者中，OS 得到了改善。这是对老年 cHL 的最大分析，表明≥60 岁的患者与 40-59 岁的患者不同。年龄≥60 岁应该在未来的临床试验中进行分层，值得进行专门的研究。提高治疗的完成率并将治疗导向学术中心可能会改善结局。
