Hodgkin's disease in the elderly: current status and future directions

In general, it was agreed that high rates of toxicities during treatment occur in the elderly and that there is a frequent occurrence of early relapse. It is clear that different combinations of effective therapies with lower toxicity are required. It was felt, however, that certainly in the 60-70 year age group, approaches should be vigorous to and the same diagnostic and staging procedures as in younger individuals, but with much closer monitoring of toxicity and response to treatment. It was felt that as part of the approach, liberal support with haemopoeitic growth factors (G-CSF) was necessary to reduce prolonged neutropenia. It is important to understand that age in general is not a contrary indication for aggressive treatment and that biologically younger patients under the age of 65 years, in good physical and mental condition, often should be given with stage-adapted treatment, analogous to conventional treatment protocols for the <60 years age group. It was also considered that, in patients who clearly could not accept conventional treatment, study groups could begin to define the best palliative care for patients with pre-existing organ impairment, and that in all situations of assessment, whether in trial or not, there should be a detailed prospective assessment of quality of life parameters.