Management of Hodgkin Lymphoma - Episode 4

Management of Hodgkin Lymphoma in Elderly Patients

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Managing comorbid illnesses and poor tolerance to chemotherapy is a challenge facing the treatment of elderly patients with Hodgkin lymphoma. Despite perceptions that Hodgkin lymphoma is predominantly a disease affecting the young, approximately 10% to 15% of patients are over the age of 60, Paul A. Hamlin, MD, points out. In general, these patients do not respond as favorably to treatment and experience higher rates of toxicity than young patients.

Several factors may impact the tolerability of treatment for elderly patients with Hodgkin lymphoma, such as less cardiopulmonary reserve, immunosenescence, and increased Epstein Barr Virus interaction, the panel agrees. However, at this point, research to support a single factor is lacking and studies in this population are hard to conduct.

Regardless of toxicity concerns, the goal is to treat patients with curative intent, Craig H. Moskowitz, MD, adds. Comparing outcomes between elderly and young patients with Hodgkin lymphoma may seem like a sharp contrast. However, if you compare elderly patients with Hodgkin's to those with other diseases the outcomes look very favorable, Moskowitz believes.