Tóthfalusi Dávid, Dobó Boglárka, Borics Fanni, Pinczés László Imre, Illés Árpád, Miltényi Zsófia
Division of Haematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Doctoral School of Clinical Medicine, University of Debrecen, 4032 Debrecen, Hungary.
Clin Pract. 2025 Jan 13;15(1):15. doi: 10.3390/clinpract15010015.
: Hodgkin lymphoma (HL) primarily affects young adults, but about 20% of cases occur in patients over the age of 60 years. Older individuals often have comorbidities and poorer functional status, which can affect treatment choices. : We retrospectively analyzed data from HL patients over 60 years old who were treated at our institution between January 2010 and December 2023. We examined various factors, such as blood parameters (e.g., platelet count, lactate dehydrogenase (LDH), C-reactive protein (CRP)), PET/CT results and comorbidities (e.g., hypertension, diabetes, cardiovascular diseases), to assess their impact on overall survival (OS) and progression-free survival (PFS). Diagnostic efficiency was determined via receiver operating characteristic analysis, while the survival outcomes were evaluated using the Cox proportional hazards model. : A total of 35 patients with a median age of 68 were treated. The most common subtype was nodular sclerosis, and 72% of patients were in advanced stages at diagnosis. Treatment varied by age, with younger patients receiving ABVD and older patients (80-89) receiving brentuximab vedotin with dacarbazine. The survival of older patients, when analyzed by age groups, did not show a significant difference in the OS ( = 0.16) and PFS ( = 0.11). Comorbidities significantly worsened survival, with patients who scored > 7 on the Charlson Comorbidity Index (CCI) showing a 5-year PFS of 41.3%, compared to 91.3% for those who scored ≤ 7. Among the tested laboratory parameters, a platelet count over 310.5 G/L and an absolute lymphocyte count below 0.47 G/L were found to be independent risk factors for OS. Patients with neither or only one of these risk factors demonstrated a 5-year OS of 81.7%, whereas those presenting with both risk factors experienced a reduced 5-year OS of 70%. For PFS, a white blood cell count > 8.48 G/L, a platelet count > 310.5 G/L, and advanced age (>73.5 years) were identified as significant adverse prognostic factors. Patients with none of these risk factors had a 5-year PFS of 100%, whereas those with ≥ 1 risk factor had a 5-year PFS of 35.6%. : Comorbidities play a greater role in prognosis than chronological age, emphasizing the need for personalized treatment approaches.
霍奇金淋巴瘤（HL）主要影响年轻成年人，但约20%的病例发生在60岁以上的患者中。老年个体常有合并症且功能状态较差，这会影响治疗选择。我们回顾性分析了2010年1月至2023年12月期间在我们机构接受治疗的60岁以上HL患者的数据。我们检查了各种因素，如血液参数（如血小板计数、乳酸脱氢酶（LDH）、C反应蛋白（CRP））、PET/CT结果和合并症（如高血压、糖尿病、心血管疾病），以评估它们对总生存期（OS）和无进展生存期（PFS）的影响。通过受试者工作特征分析确定诊断效率，同时使用Cox比例风险模型评估生存结果。共治疗了35例中位年龄为68岁的患者。最常见的亚型是结节硬化型，72%的患者在诊断时处于晚期。治疗因年龄而异，年轻患者接受ABVD方案，老年患者（80 - 89岁）接受本妥昔单抗联合达卡巴嗪治疗。按年龄组分析老年患者的生存情况，其OS（P = 0.16）和PFS（P = 0.11）未显示出显著差异。合并症显著恶化生存情况，Charlson合并症指数（CCI）评分>7分的患者5年PFS为41.3%，而评分≤7分的患者为91.3%。在检测的实验室参数中，血小板计数超过310.5 G/L和绝对淋巴细胞计数低于0.47 G/L被发现是OS的独立危险因素。既无这些危险因素之一或仅有其中一个危险因素的患者5年OS为81.7%，而同时存在两个危险因素的患者5年OS降低至70%。对于PFS，白细胞计数>8.48 G/L、血小板计数>310.5 G/L和高龄（>73.5岁）被确定为显著的不良预后因素。无这些危险因素的患者5年PFS为100%，而有≥1个危险因素的患者5年PFS为35.6%。合并症在预后中比实际年龄起更大作用，强调了个性化治疗方法的必要性。
