Background: Hodgkin's Lymphoma (HL) in elderly patients often manifests different biological and clinical characteristics than younger populations. Variations include tumor biology, genetic mutations, and comorbidities affecting disease prognosis and treatment efficacy (TE). Elderly patients may present more advanced stages of the disease or more aggressive symptoms, causing delays in diagnosis and treatment initiation. This study aims to evaluate TE, overall survival (OS), and disease-free survival (DFS) among elderly (≥ 60 years) and young (<60 years) HL patients.
Methods: A retrospective cohort using clinical records of HL patients treated in our institution over the past ten years. Completed clinical records of adult patients diagnosed and treated by the Hematology Department were included.
Results: The study analyzed 207 clinical records, including 185 patients under 60 years of age and 22 patients aged 60 years or older. Among these, 134 patients were male. The most common histopathological subtype was mixed cellularity, observed in 62.8% of the cases. In patients aged 60 years or older, there was a significant increase in Epstein-Barr Virus (EBV) positivity, ECOG scores, and clinical status compared to the younger group. Radiotherapy was administered to both groups at similar rates, with 26.5% of patients under 60 years and 22.7% of patients aged 60 years or older receiving this treatment. Multivariate analysis exhibits statistically significant differences in TE and DFS between groups (OR: 5.617, 95% CI: 2.051 – 15.386, p < 0.000 and OR: 7.470, 95% CI: 2.412 – 23.131, p < 0.000, respectively). However, the OS did not show a statistical difference (p = 0.246). The median OS was 11 months (range 2 – 54 months) for the under 60 years group and 8 months (range 2 – 34 months) for the 60 years or older group. Mantel-Cox analysis was made to compare OS and DFS at a five-year follow-up, leading to a statistical difference between groups with a major and better prognosis for the under 60 years patients (Log-Rank: 0.009 and 0.000 respectively) (Figure 1).
Conclusions: Our population behaved similarly to other world study populations. There is a need to adapt treatment regimens to balance efficacy with tolerability, especially in older populations. Studying OS and DFS in elderly HL patients provides insights into the effectiveness of current treatments and helps assess long-term treatment success and the risk of relapse.
Gerardo Santiago Jimenez, Alonso Hernández Company, Karen Torres Castellanos, Gilberto Israel Barranco Lampón, Juan Francisco Zazueta Pozos, Daniela de Jesús Pérez Sámano, Emmanuel Martínez Moreno, Carlos Martínez Murillo, Adán Germán Gallardo, Omar Ramos Peñafiel Christian