In a nutshell
This study compared the survival outcomes of two different age groups of relapsed and refractory Hodgkin lymphoma patients. The authors concluded that co-morbidities, not age, reduced survival rates after stem-cell surgery.
Some background
Hodgkin lymphoma (HL) is a type of cancer of the lymph system. It is generally highly curable. Some patients, however, are either unresponsive to treatment (refractory disease) or relapse soon afterwards. The standard treatment for these patients includes stem cell transplantation. This treatment, however, is only successful in 40-50% of cases.
20% of HL occurs in patients older than 60 years. Older patients have lower survival rates than younger patients. Older patients also tend to have other medical conditions (co-morbidities). It is not clear whether comorbidities affect the success of stem cell transplantation in older relapsed and refractory patients.
Methods & findings
This study determined whether co-morbidities affected survival among older, relapsed and refractory disease patients.
This study examined the records of 121 patients with relapsed or refractory HL. 65% were aged 50-59 years. 35% were aged over-60 years. The number of comorbidities was measured for all patients at the start of the study. Patients were followed for an average of 3.1 years.
67% of patients were alive at last follow-up. There were four transplant-related deaths and ten secondary-tumor developments. There was no difference in survival rates or toxicities between the two age-groups examined. The overall survival (OS; time from treatment until death from any cause) at five years was 64%. The 5-year progression-free survival (time from treatment until disease progression) was 55%. Patients with more co-morbidities had lower survival rates. Higher rates of co-morbidities were 3.4-3.6 times more likely to predict OS. They were also 2.4-2.5 more likely to predict PFS.
The bottom line
The authors concluded that co-morbidities, not age, impacted post-stem-cell-surgery survival among patients older than 50.
The fine print
Prospective trials (selecting eligible patients during salvage therapy instead of during time-of-surgery) are needed.
Published By :
Annals of Hematology
Date :
Jan 01, 2017
Good to know as care-giver for 71 y.o. MDS female who’s in very good general health. Even though the information is a bit thick on the medical jargon, the last sentence is easy enough to understand: “Our data show that AHCT (auto hematopoietic cell transplant) can be performed in selected patients with R/R HL ≥50 years with acceptable outcome and toxicity. Comorbidities appear to impact AHCT outcome more than age.”
Someone might look at how difficult the abstract is to find from this page, however. I found it by clicking on the green link square just under the date.