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Relapsed Hodgkin lymphoma in older patients: a comprehensive analysis from the German Hodgkin Study Group

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...

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Hauptverfasser: Böll, Boris (VerfasserIn) , Goergen, Helen (VerfasserIn) , Arndt, Nils (VerfasserIn) , Meißner, Julia (VerfasserIn) , Krause, Stefan W. (VerfasserIn) , Schnell, Roland (VerfasserIn) , von Tresckow, Bastian (VerfasserIn) , Eichenauer, Dennis A. (VerfasserIn) , Sasse, Stephanie (VerfasserIn) , Fuchs, Michael (VerfasserIn) , Behringer, Karolin (VerfasserIn) , Klimm, Beate C. (VerfasserIn) , Naumann, Ralph (VerfasserIn) , Diehl, Volker (VerfasserIn) , Engert, Andreas (VerfasserIn) , Borchmann, Peter (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: November 04, 2013
In: Journal of clinical oncology
Year: 2013, Jahrgang: 31, Heft: 35, Pages: 4431-4437
ISSN:1527-7755
DOI:10.1200/JCO.2013.49.8246
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1200/JCO.2013.49.8246
Verlag, lizenzpflichtig, Volltext: https://ascopubs.org/doi/10.1200/JCO.2013.49.8246
Volltext
Verfasserangaben:Boris Böll, Helen Goergen, Nils Arndt, Julia Meissner, Stefan W. Krause, Roland Schnell, Bastian von Tresckow, Dennis A. Eichenauer, Stephanie Sasse, Michael Fuchs, Karolin Behringer, Beate C. Klimm, Ralph Naumann, Volker Diehl, Andreas Engert, and Peter Borchmann
Beschreibung
Zusammenfassung: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.
Beschreibung:Gesehen am 27.11.2020
Beschreibung:Online Resource
ISSN:1527-7755
DOI:10.1200/JCO.2013.49.8246

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