Wahlin Björn Engelbrekt, Övergaard Ninja, Peterson Stefan, Digkas Evangelos, Glimelius Ingrid, Lagerlöf Ingemar, Johansson Ann-Sofie, Palma Marzia, Hansson Lotta, Linderoth Johan, Goldkuhl Christina, Molin Daniel
Division of Haematology, Department of Medicine, Huddinge Karolinska Institutet Stockholm Sweden.
Haematology unit Karolinska University Hospital Stockholm Sweden.
EJHaem. 2021 May 6;2(3):400-412. doi: 10.1002/jha2.202. eCollection 2021 Aug.
Treatment for patients > 60 years with classical Hodgkin lymphoma (cHL) is problematic; there is no gold standard, and outcome is poor. Using the Swedish Lymphoma Registry, we analysed all Swedish patients diagnosed with cHL between 2000 and 2014 ( = 2345; median age 42 years; 691 patients were >60 years). The median follow-up time was 6.7 years. Treatment for elderly patients consisted mainly of ABVD or CHOP, and the younger patients were treated with ABVD or BEACOPP (with no survival difference). In multivariable analysis of patients > 60 years, ABVD correlated with better survival than CHOP ( = 0.027), and ABVD became more common over time among patients aged 61-70 years ( = 0.0206). Coinciding with the implementation of FDG-PET/CT, the fraction of advanced-stage disease increased in later calendar periods, also in the older patient group. Survival has improved in cHL patients > 60 years ( = 0.027), for whom ABVD seems superior to CHOP.
60岁以上经典型霍奇金淋巴瘤(cHL)患者的治疗存在问题;没有金标准,且预后较差。利用瑞典淋巴瘤登记处的数据,我们分析了2000年至2014年间所有在瑞典被诊断为cHL的患者(n = 2345;中位年龄42岁;691名患者年龄>60岁)。中位随访时间为6.7年。老年患者的治疗主要包括ABVD或CHOP方案,而年轻患者则接受ABVD或BEACOPP方案治疗(生存率无差异)。在对60岁以上患者的多变量分析中,ABVD方案与比CHOP方案更好的生存率相关(P = 0.027),并且随着时间的推移,ABVD方案在61 - 70岁患者中变得更为常见(P = 0.0206)。与FDG - PET/CT的应用同时发生的是,在随后的日历期内,晚期疾病的比例增加,在老年患者组中也是如此。60岁以上cHL患者的生存率有所提高(P = 0.027),对于他们来说,ABVD方案似乎优于CHOP方案。