Hodgkin's disease in the elderly: Improved treatment outcome with a doxorubicin-containing regimen

Colin D. Weekes, Julie M. Vose, Jim C. Lynch, Dennis D. Weisenburger, Philip J. Bierman, Timothy Greiner, Gregory Bociek, Charles Enke, Martin Bast, Wing C. Chan, James O. Armitage

Research output: Contribution to journalArticlepeer-review

74 Scopus citations

Abstract

Purpose: Hodgkin's disease (HD) is a malignancy that displays a bimodal age distribution. Previous reports of treatment in patients ≥ 60 years have found a poor outcome, particularly in patients with advanced disease. Because of an improved side-effect profile, the regimen of chlorambucil, vinblastine, procarbazine, and prednisone (ChlVPP) has been proposed for use in elderly patients. Patients and Methods: From September 1982 to May 1998, 262 patients with previously untreated HD received either ChlVPP (n = 176) or ChlVPP plus doxorubicin/bleomycin/vincristine (ChlVPP/ABV hybrid; n = 86). Fifty-six patients were ≥ 60 years old, and 206 were younger than 60 years. Results: The 5-year overall survival (OS; 87% v39%) and the 5-year event-free survival (EFS; 75% v 31%) favored patients younger than 60 years of age. Prognostic factors analyzed in patients ≥ 60 years of age, other than type of therapy, included sex, stage, Karnofsky performance score, lactic dehydrogenase, number of extranodal sites, B symptoms, size of largest mass, and histologic subtype. In patients older than 60 years, none of the clinical features was a statistically significant predictor of EFS; however, ChlVPP/ABV hybrid was associated with a decreased risk of an event (relative risk, 0.40; 95% confidence interval, 0.19 to 0.83; P = .014) compared with ChlVPP. The 5-year OS for patients ≥ 60 years who received ChlVPP was 30%, compared with 67% for those patients receiving the ChlVPP/ABV regimen (P = .0086) Conclusion: Patients ≥ 60 years with HD who require chemotherapy are better treated with ChlVPP/ABV hybrid than with ChlVPP alone.

Original languageEnglish (US)
Pages (from-to)1087-1093
Number of pages7
JournalJournal of Clinical Oncology
Volume20
Issue number4
DOIs
StatePublished - Feb 15 2002

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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