Clinical Characteristics and Outcome of Patients With Hodgkin's Lymphoma Older Than 60 Years Treated in Switzerland Over the Last 17 Years

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Introduction: Approximately 20% of Hodgkin lymphoma (HL) patients (pts) are older than 60 years at diagnosis. Despite the fact that HL remains a highly curable disease, this particular group of pts tends to have a less favorable outcome than their younger counterparts. This is mainly related to the increased toxicity resulting in higher treatment-related mortality and insufficient dosing of the drugs applied. Methods: We conducted a population-based, retrospective analysis which aimed to investigate patient characteristics, treatment strategies and outcome of pts with HL older than 60 years of age, treated between 2000 and 2017, in 15 Centers across Switzerland. Results: We identified 249 pts with the following characteristics: Median age at diagnosis 71 years (range: 60-94), 123 pts 60-70 years, 89 pts 71 – 80 years, 37 pts > 80 years. 158 (63.5%) male, 191 (81.7%) Performance Status (PS) 0-1, Charlson Comorbidity Index (CCI) low (2-4 points) in 42 (16.9%) pts and high (> 4 points) in 205 (82.3%) pts. 121 (49%) pts with stage I/II ; 126 (51%) with stage III/IV and the following histologies: 238 (96%) classical HL, 11 (4%) nodular lymphocyte predominant HL. Treatment was performed as follows: radiotherapy (RT) only in 11 (4%) pts; chemotherapy followed by RT in 79 (32%) pts, chemotherapy only 142 (57%) pts; 221 pts received systemic therapy with: ABVD 117 (53 %); BEACOPPesc. 8 (4.0 %), other chemotherapy combinations or single agent 57 (25 %), antibody drug conjugate one pt; 12 (5.0 %) pts received best supportive care, in 5 (2%) pts information was missing. Haematological toxicity ≥G2 was observed in 111 (42.7%) pts, 65 (25%) pts presented with infections and 44 (17%) pts with febrile neutropenia. Bleomycin lung-toxicity (BLT) was documented in 25 (18%) pts: 6 (4 %) pts had mild toxicity (radiologic changes only), 12 (9%) pts had severe toxicity (leading to hospitalization), in 7 (5%) pts severity was unknown. In 58 (24%) pts treatment was discontinued prematurely due to toxicity. 171 (68.7%) pts achieved complete remission, 30 (12%) partial response. 58 (23%) pts relapsed/progressed after first line treatment. 25 (23%) pts died of HL and 15 (14%) of treatment toxicity. With a median follow-up of 4.1 years (range: 0.05 - 17.95) for the whole study population, progression-free survival (PFS) at 2 and 5 years was 81% and 72% respectively, cause-specific survival (CSS) at 2 and 5 years was 85% and 78%, respectively. CSS for pts 71-80 years vs 60-70 years; HR = 3.25, p<0.001 and > 80 years vs 60-70 years; HR 3.84, p = 0.001. Keywords: elderly; Hodgkin lymphoma (HL). Disclosures: Moccia, A: Other Remuneration: Advisory Roche, Janssen, Takeda.