A retrospective study in the Journal of Clinical Oncology shows that for patients over 60 with relapsed or refractory Hodgkin's lymphoma the prognosis remains poor.
Reporting in the JCO, the German Hodgkin's Study Group identified 105 patients (median age, 66) from between 1993 and 2007 diagnosed with relapsed or refractory Hodgkin's, with the intent on identifying whether a second-line therapy might emerge as a preferred treatment.
They found that second-line treatment strategies had varied considerably, and included intensified salvage regimens (22 percent), conventional combination chemotherapy and/or salvage-radiotherapy with curative intent (42 percent), and palliative approaches (31 percent). Key findings included:
- The median overall survival (OS) for the entire cohort was 12 months.
- Overall survival at 3 years was 31 percent.
- A prognostic score with risk factors (RFs) of early relapse, clinical stage III/IV, and anemia identified patients with favorable and unfavorable prognosis.
- In low-risk patients, the impact of therapy on survival was significant in favor of the conventional combination chemotherapy/salvage radiotherapy approach.
- In high-risk patients, overall survival was low overall and did not differ significantly among treatment strategies.
While they concluded that prognosis can be determined by examining the risk factors, they also concluded that "Poor outcome in high-risk patients cannot be overcome by any of the applied treatment strategies."
Source: JCO