New Scoring Helps Predict Overall Survival in Older Hodgkin's Patients

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New findings from the German Hodgkin's Study Group (GHSG) indicate that a simple prognostic score can predict overall survival (OS) among older Hodgkin's patients whose disease is refractory or who have relapsed following frontline therapy.

Researchers screened 105 patients (median age 66) from GHSG frontline therapy studies between the years 1993 and 2007 looking for older patients with relapsed or refractory disease.

They found that 28 percent had progressive disease, 31 percent had early relapse and 41 percent had late relapse.

Effects of second-line treatment

It is not uncommon among this age group with Hodgkin's for their disease to progress, even after frontline therapy. The questions were to determine prognosis and effects of second-line treatments among this population.

Second-line treatments (and the percentage of patients receiving them) included:

  • Combination chemotherapy regimens (42 percent)
  • Palliative therapy (31 percent)
  • Intense salvage regimens (22 percent)

At three years, the median overall survival for all patients was 31 percent.

Examining risk factors

Researchers applied three risk factors:

  1. Early relapse (or relapse 12 months from the end of frontline therapy)
  2. The development of anemia (hemoglobin 12 g/dL in men and 10.5 g/dL in women)
  3. Stage III or IV disease at relapse

Their findings showed that patients with either zero or one risk factor had a three-year OS of 59 percent; meanwhile, patients with two or more risk factors had an OS of just 9 percent.

Impact on survival

Investigators concluded:

In low-risk patients, the impact of therapy on survival was significant in favor of the conventional polychemotherapy/salvage radiotherapy approach. In high-risk patients, OS was low overall and did not differ significantly among treatment strategies.

Researchers believe that their prognostic score can predict OS in these patients, and that their findings can help doctors with making the right treatment decisions.

Source: JCO

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