Prognostic factors in elderly patients with classical hodgkin lymphoma ‐ a joint analysis of two clinical databases

Background: Prognostic factors for elderly patients ≥60 years of age with classical Hodgkin Lymphoma (cHL) are not well established. Previous studies have shown that patient-related factors such as comorbidities and performance status (ECOG-PS), disease-specific factors (extranodal disease) and markers of host inflammation (e.g. neutrophil-lymphocyte ratio [NLR]) can be associated with clinical outcomes in elderly patients with cHL. Therefore the aim of this study was to evaluate the association of cause-specific survival (CSS) and overall survival (OS) with age, stage, Charlson comorbidity index (CCI) and these additional patient- and disease-related factors in a large dataset of elderly patients with cHL. Method: Joint analysis of Princess Margaret and Swiss elderly cHL databases of patients from 2000 to 2018. Main inclusion criteria were age ≥60 years, diagnosis of cHL, treatment with chemotherapy (CT) or combined modality therapy (CMT). Patients with nodular-lymphocyte predominate HL (NLPHL) and treated with radiotherapy alone were excluded. Univariable and multivariable models were applied. Results: Overall, 309 patients from 1 Canadian (n = 72) and 15 Swiss centers (n = 237) were included. Excluded were 10 patients with RT alone and 11 with NLPHL. Median age was 70 years (range 60 – 91), median CCI was 7 (4 – 16), 17.2% of patients had stage I, 30.1 % stage II, 29.9% stage III and 28.5% stage IV cHL. Overall, 5-years OS was 62.4% [95%CI 56.8 – 68.5] and 5-years CSS was 82.6% [78.1 – 87.4]. 189 (61.2%) patients were treated with CT alone, 120 (38.8.%) patients with CMT; 240 (77.7%) patients received anthracycline-containing CT, 69 (22.3%) patients received non-anthracycline-containing CT. In univariable analysis, age, stage, CCI, NLR and ECOG-PS showed significant associations with both endpoints, all p-values < 0.01. Results of the multivariable analysis are demonstrated in table1. Conclusion: In this large, international cohort of patients aged ≥60 years with cHL age, CCI and ECOG-PS are independent factors associated with OS. Age and stage are independently associated with cause-specific survival while NLR and extranodal disease are not independently associated with clinical outcomes. *contributed equally Keywords: Diagnostic and Prognostic Biomarkers, Hodgkin lymphoma No conflicts of interest pertinent to the abstract.