CLINICAL CHARACTERISTICS AND OUTCOME OF PATIENTS WITH HODGKIN'S LYMPHOMA OLDER THAN 60 YEARS TREATED IN SWITZERLAND OVER THE LAST 17 YEARS
Notice bibliographique
Résumé
Introduction: Approximately 20% of Hodgkin lymphoma (HL) patients (pts) are older than 60 years at diagnosis. Despite the fact that HL remains a highly curable disease, this particular group of pts tends to have a less favorable outcome than their younger counterparts. This is mainly related to the increased toxicity resulting in higher treatment-related mortality and insufficient dosing of the drugs applied. Methods: We conducted a population-based, retrospective analysis which aimed to investigate patient characteristics, treatment strategies and outcome of pts with HL older than 60 years of age, treated between 2000 and 2017, in 15 Centers across Switzerland. Results: We identified 249 pts with the following characteristics: Median age at diagnosis 71 years (range: 60-94), 123 pts 60-70 years, 89 pts 71 – 80 years, 37 pts > 80 years. 158 (63.5%) male, 191 (81.7%) Performance Status (PS) 0-1, Charlson Comorbidity Index (CCI) low (2-4 points) in 42 (16.9%) pts and high (> 4 points) in 205 (82.3%) pts. 121 (49%) pts with stage I/II ; 126 (51%) with stage III/IV and the following histologies: 238 (96%) classical HL, 11 (4%) nodular lymphocyte predominant HL. Treatment was performed as follows: radiotherapy (RT) only in 11 (4%) pts; chemotherapy followed by RT in 79 (32%) pts, chemotherapy only 142 (57%) pts; 221 pts received systemic therapy with: ABVD 117 (53 %); BEACOPPesc. 8 (4.0 %), other chemotherapy combinations or single agent 57 (25 %), antibody drug conjugate one pt; 12 (5.0 %) pts received best supportive care, in 5 (2%) pts information was missing. Haematological toxicity ≥G2 was observed in 111 (42.7%) pts, 65 (25%) pts presented with infections and 44 (17%) pts with febrile neutropenia. Bleomycin lung-toxicity (BLT) was documented in 25 (18%) pts: 6 (4 %) pts had mild toxicity (radiologic changes only), 12 (9%) pts had severe toxicity (leading to hospitalization), in 7 (5%) pts severity was unknown. In 58 (24%) pts treatment was discontinued prematurely due to toxicity. 171 (68.7%) pts achieved complete remission, 30 (12%) partial response. 58 (23%) pts relapsed/progressed after first line treatment. 25 (23%) pts died of HL and 15 (14%) of treatment toxicity. With a median follow-up of 4.1 years (range: 0.05 - 17.95) for the whole study population, progression-free survival (PFS) at 2 and 5 years was 81% and 72% respectively, cause-specific survival (CSS) at 2 and 5 years was 85% and 78%, respectively. CSS for pts 71-80 years vs 60-70 years; HR = 3.25, p<0.001 and > 80 years vs 60-70 years; HR 3.84, p = 0.001. Keywords: elderly; Hodgkin lymphoma (HL). Disclosures: Moccia, A: Other Remuneration: Advisory Roche, Janssen, Takeda.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».