Abstract P079

Anthracycline-based therapy for elderly HL patients : a retrospective series from a single South Italy center.

Background: Elderly patients account for about 20% of newly diagnosed Hodgkin lymphoma (HL) cases. For these patients, outcomes have traditionally been poor due to the negative prognostic factors associated to the disease and due the presence of comorbidities that may also make it difficult to administer anthracycline-based chemotherapy such as ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) with a curative intent. The aim of this study was to evaluate the treatment patterns and survival in patients aged ≥60 years treated with anthracycline-based CT.

Patients and Methods: Patients aged ≥60 years diagnosed with HL from 1995 to 2023 were retrospectively identified at Cervello Hospital in Palermo and those treated with anthracycline-based chemotherapy (CT) were included in this analysis. Anthracycline-based CT consisted of ABVD, MyocetBVD, VEPEMB, AVD, Adcetris+AVD. Data on clinical characteristics, baseline assessment including echocardiogram and spirometry, treatment response, toxicities, survival estimates were calculated.

Results: 116 HL patients were identified and 98 pts (84%) received anthracycline-based CT as follows: ABVD 46, MyBVD 4, VEPEMB 12, AVD 11, A+AVD 2. Median age was 69 years (range 60-85). At diagnosis, 18 pts (18%) had localized disease (I-IIA) and 80 (82%) an advanced stage (IIB-IVB). Before treatment, all patients performed baseline echocardiogram and spirometry. Abnormalities were reported in 8% of patients. The median number of CT cycles was 6 (range 1-8). In the advanced stage cohort, 25% of patients were not able to perform treatment schedule due PD in 11, CT toxicity in 5, UK in 4. 85 (87%) patients were evaluable for dose reduction and in 20 (24%) doses were reduced because of toxicity. The end of treatment (EOT) ORR was 83% (CR 76%, PR 7%). With a median follow-up of 4.2 years for all patients, 5-year PFS and OS were 56% and 65%, respectively. In univariate analysis, age less than 69 years predicted better PFS and OS than those aged more than 70 (p < .0001) (figure 1).

Conclusions: Our findings suggest that anthracycline-based CT is feasible in most of elderly patients, although 25% of advanced cohort was not able to complete the treatment, mainly because of lack of response. The EOT ORR was similar to that reported in younger patients. However, the survival for the whole cohort was reduced, even if better in patients aged less 70 years.