Turkish Journal of Geriatrics 2003 , Vol 6, Issue 1
PATIENTS WITH HODGKIN'S LYMPOMA WHO WERE 60 YEARS OR OLDER, FOLLOWED-UP AT HACETTEPE UNIVERSITY INSTITUTE OF ONCOLOGY
Saadettin KILIÇKAP, Hüseyin ABALI, İbrahim BARIŞTA, Gülten TEKUZMAN
Hacettepe Ãœniversitesi Tıp Fakültesi İç Hastalıkları A.D. Tıbbi Onkoloji Ãœnitesi, Ankara Survival of patients with Hodgkin’s lymphoma (HL) has significantly improved within the recent 20 years with use of effective treatment modalities; however, compared to their younger counterparts the mortality rate is still high in the elderly group. Medical records of 18 patients with HL who were 60 years of age or older, treated and followed-up at Hacettepe University Institute of Oncology, have been retrospectively reviewed. The clinical characteristics, response to therapy, and factors affecting the survival were investigated. Median age was 62 years, the oldest patient being 77 years old. Fifteen (83.3%) were male and three (16.7%) were female. The mixed cellularity subtype was found in 9 (50%) patients. B symptoms were present in 9 (61.1%) and extranodal involvement in 5 (27.8%) cases. Seven (61.1%) patients initially presented with advanced stage (III or IV) disease. ABVD, COPP, and MOPP regimens were given as first-line chemotherapy to 2, 6, and 5 patients, respectively. Radiotherapy alone was employed in 3 patients as a first-line modality. Two patients did not receive chemotherapy or radiotherapy; as a result of rapid disease progression, in one and acute myocardial infarction in an other patients. Median progression-free and overall survival was 49 and 32 months, respectively. Factors adversely affecting the survival were fever (p = 0.0043), advanced stage (p = 0.012), and lower performance status (p = 0.044). Elderly patients with HD should be considered as a special group because of the presence of comorbid diseases, decreased tolerance to chemotherapy, and relatively poor prognosis in this group. Keywords : Elderly, Hodgkin’s disease, prognosis, therapy, prognostic factors