Characteristics and Outcomes of Older Patients With Classical Hodgkin Lymphoma: An Australasian Lymphoma Alliance, and Lymphoma and Related Diseases Registry Study

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Goh, Zhong
Latimer, Maya
Lewis, Katharine L
Cheah, Chan Y
Di Ciaccio, Pietro
Cushion, Tania
Hawkes, Eliza A
Harrop, Sean
Ku, Matthew
Campbell, Ashlea
Hamad, Nada
Wood, Erica M
Chung, Eliza
Chen, Pin-Yen
Cochrane, Tara
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2023
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Abstract

Background: There is no standard front-line therapy for older patients with classical Hodgkin lymphoma (cHL). We analyzed the clinical presentation and front-line management of older Australian patients with cHL and explored factors associated with unplanned hospital admission and survival. Methods: Patients aged ≥ 61 years and diagnosed between 2011 and 2020, were retrospectively identified through the Lymphoma and Related Diseases Registry (LaRDR) and Australasian Lymphoma Alliance (ALA) institutional databases. Descriptive statistics and Kaplan-Meier survival analyses were performed using STATA-v17. Results: 195 patients were identified, 72 from LaRDR,123 from ALA. Median age of the combined cohort was 72 years (range 61-93); 56.4% male, 35.3% had stage I-II, bulk present in 9.2%, 33.9% had extra-nodal disease and 48.2% had B-symptoms. Chemotherapy was commenced in 91.3% of patients, with an anthracycline-based regimen used in 81%. Median number of cycles given for stage I-II was 2 and for stage III-IV was 6. Radiotherapy was administered in 26.2% of patients. A complete remission to front-line chemotherapy was achieved in 60.7% of patients. During front-line therapy in the ALA cohort, 89 unplanned hospitalizations occurred in 58 patients, with infection accounting for 59.6% of admissions. Treatment-related mortality was 5.2%. Only performance status and anthracycline use correlated with unplanned hospitalizations. Estimated 2-year progression free survival was 63.7% and 2-year overall survival was 71.2%. Anthracycline use and younger age were independently associated with improved survival. Conclusion: The management of older patients with cHL in Australia is diverse but aligns with international data. Anthracycline-based therapy improved survival but resulted in frequent unplanned hospitalizations.

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Clinical Lymphoma Myeloma and Leukemia

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23

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5

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Cardiovascular medicine and haematology

Oncology and carcinogenesis

Science & Technology

Life Sciences & Biomedicine

Oncology

Hematology

Anthracycline

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Goh, Z; Latimer, M; Lewis, KL; Cheah, CY; Di Ciaccio, P; Cushion, T; Hawkes, EA; Harrop, S; Ku, M; Campbell, A; Hamad, N; Wood, EM; Chung, E; Chen, P-Y; Cochrane, T, Characteristics and Outcomes of Older Patients With Classical Hodgkin Lymphoma: An Australasian Lymphoma Alliance, and Lymphoma and Related Diseases Registry Study,Clinical Lymphoma Myeloma and Leukemia, 2023, 23 (5), pp. 370-378

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