Abstract P096

Frailty as a predictor of survival in older patients with classical Hodgkin lymphoma: A retrospective, multicenter study from the RELINF Spanish Lymphoma Registry of the GELTAMO Spanish Lymphoma Group

Introduction: Survival among older patients with classical Hodgkin lymphoma (cHL) has improved in recent decades. However, outcomes remain poor in patients aged ≥70 years. Frailty has been associated with inferior outcomes and reduced treatment tolerance in hematologic malignancies. Although geriatric assessment is recommended to guide treatment decisions, its implementation in routine practice remains limited.

Objectives: To evaluate the impact of comorbidities and frailty on clinical outcomes in older patients with cHL included in the Spanish Lymphoma Registry (RELINF) of the GELTAMO group.

Methods: We conducted a retrospective multicenter study including 673 patients aged ≥60 years with cHL from 46 Spanish centers. Baseline characteristics, activities of daily living (ADL), instrumental activities of daily living (IADL), geriatric syndromes, and comorbidities were collected. Comorbidities were assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G). Statistical analyses were performed using R.

Results: Median age at diagnosis was 72 years (range, 60–93); 57.8% were male, 65.7% had advanced-stage disease, and 43.9% had extranodal involvement. CIRS scores were available for 417 patients (median, 4; range, 0–13). ADL impairment was present in 13.9%, IADL impairment in 17.7%, and geriatric syndromes in 14.4% of evaluated patients. In the univariate analysis, older age, cardiovascular disease, extranodal involvement, advanced stage, ECOG >2, ADL and IADL impairment, geriatric syndromes, cardiac and psychiatric comorbidities were associated with worse overall survival. Among laboratory parameters, absolute lymphocyte count, hemoglobin, albumin, and erythrocyte sedimentation rate were associated with survival. No significant differences were observed among treatment approaches except for palliative regimens, which were associated with inferior survival (HR 11.5; 95% CI, 7.73–17.2; p<0.001). In the multivariate analysis, age, ECOG performance status, anemia, geriatric syndromes, and palliative treatment remained independently associated with overall survival.

Conclusions: Functional reserve and resilience significantly influence survival in older patients with cHL. Comprehensive geriatric assessment should be systematically incorporated into routine clinical practice to identify frailty and patients at higher risk. More effective and safer therapeutic strategies are needed to improve outcomes in this population.