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Hodgkin's disease in the elderly: a population-based study.
Gail L Stark1, Katrina M Wood, Fergus Jack
1University Department of Haematology, Royal Victoria Infirmary, Newcastle upon Tyne, UK. g.l.stark@ncl.ac.uk
British Journal of Haematology
|October 31, 2002
Summary
This study found Hodgkin's disease (HD) incidence in older adults and revealed poorer prognoses for those with advanced stages. Elderly patients with Epstein-Barr virus-positive tumors had significantly worse survival rates, necessitating new treatment strategies.
Area of Science:
- Oncology
- Epidemiology
- Geriatric Medicine
Background:
- Hodgkin's disease (HD) prognosis has improved for younger patients.
- Limited data exists on HD incidence and outcomes in elderly populations.
Purpose of the Study:
- To evaluate the incidence and outcomes of Hodgkin's disease in patients aged 60 years and older.
- To identify prognostic factors influencing survival in elderly HD patients.
Main Methods:
- Population-based prospective study of 102 patients aged >= 60 years in Northern England (1991-1998).
- Analysis of age-specific incidence, treatment response, disease-specific survival, and impact of Epstein-Barr virus (EBV) status.
Main Results:
- Age-specific incidence of HD was 1.97/100,000 (60-69 years) and 2.18/100,000 (>=70 years).
- 5-year disease-specific survival varied significantly by age and stage: 100% (early stage, 60-69) to 14% (advanced stage, >=70).
- EBV-positive tumors correlated with significantly poorer survival (median 20 months vs. undefined).
Conclusions:
- Elderly patients with advanced stage Hodgkin's disease have a poor prognosis.
- Survival outcomes for older HD patients have not improved comparably to younger cohorts.
- Novel therapeutic and assessment approaches are required for elderly HD patients.