Hodgkin's disease in the elderly: a retrospective clinicopathologic study of 61 patients aged over 60 years

61 cases of Hodgkin's disease (HD) with age over sixty years were diagnosed in a series of 387 patients. Mixed cellularity (57.4%) and nodular sclerosis (14.7%) were the most common histologic subtypes. Clinical presentation was characterized by superficial lymphadenopathy (92%) and/or general symptoms (57.4%). Mediastinal involvement was observed in 24.6% of cases, and 24.6% of patients had a primitive infradiaphragmatic presentation. Stage II was the most frequent (47.5%). At the onset of the disease, normal values of hemoglobin and white cells were observed while the platelet count was more variable. Only 3 patients (5%) were given radiotherapy (RT), 3 received chemotherapy (CH) plus RT, and 55 (90%) CH. Severe hematologic toxicity was observed in only 11.1% of cases. Complete remission (CR) was obtained in 37 patients (61%), 10 of whom relapsed. Elderly patients had a 5-year survival rate of 54.9%, while in younger ones it was 76.4% (p less than 0.001). Survival was strongly influenced by the achievement of CR (p less than 0.001), whereas stage, histopathology, systemic symptoms and therapeutic modalities did not correlate significantly.