Is classical Hodgkin lymphoma a different disease in the elderly? A single-center retrospective cohort study

Although the clinical features and treatment results of Hodgkin lymphoma (HL) in young adults are well known, it is thought that the disease may have different characteristics in elderly patients with HL, which constitutes almost 25% of the group. In this study, our aim is to evaluate the clinicopathological features, treatment outcomes, and survival of elderly classical Hodgkin lymphoma (CHL) patients.

Patients aged 60 and over who were treated with a diagnosis of CHL were included in our retrospective cohort study. Patients under the age of 60, those with a diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) were excluded from the study.

The median age of 51 patients in the study was 66 (60-76). Forty (78.4%) patients had at least one comorbid disease. The most common histological subtype was mixed cellular HL (n = 23, 45%) and 23 (45%) patients had B-symptoms. Thirty-two (62.8%) patients were in the advanced stage. The most preferred regimen in first-line treatment was doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) combination chemotherapy (n: 45; 88.2%). Forty-three (84.3%) patients were able to complete the initially planned treatment. Complete response was achieved in 34 (66.7%) patients. During the median follow-up period of 45.2 months, 23 (42.6%) patients had died. The 5-year OS was 57.4%.

In conclusion, it was observed that the distribution of histological subtypes was different in elderly patients with CHL, B-symptoms were more common in elderly patients, and OS decreased with increasing age.