Evaluation of treatment outcome in 175 patients with Hodgkin lymphoma aged 60 years or over: the SHIELD study

Stephen J Proctor, Jennifer Wilkinson, Gail Jones, Gillian C Watson, Helen H Lucraft, Tryfonia Mainou-Fowler, Dominic Culligan, Michael J Galloway, Katrina M Wood, Richard J Q McNally, Peter W James, John R Goodlad

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

The SHIELD program for Hodgkin lymphoma in patients 60 years of age or older, prospectively evaluated clinical features and outcome in a large patient cohort (n = 175). The central element was a phase 2 study of VEPEMB chemotherapy (n = 103, median age 73 years) incorporating comorbidity assessment. A total of 72 other patients were treated off-study but registered prospectively and treated concurrently with: ABVD (n = 35); CLVPP (n = 19), or other (n = 18). Of VEPEMB patients, 31 had early-stage disease (stage 1A/2A) and received VEPEMB 3 times plus radiotherapy. Median follow-up was 36 months. Complete remission (CR) rate (intention-to-treat) was 74% and 3-year overall survival (OS) and progression-free survival (PFS) were 81% and 74%, respectively. A total of 72 patients had advanced-stage disease (stage 1B/2B/3 or 4) and received VEPEMB 6 times. CR rate was 61% with 3-year OS and PFS of 66% and 58%, respectively. Of patients achieving CR, 13% with early-stage and 5% with advanced-stage disease progressed. Overall treatment-related mortality was 7%. In patients treated with curative intent with VEPEMB, ABVD, and CLVPP (n = 157), CR linked to several factors in univariate analysis. In a Cox regression model only, obtaining CR remained significant for OS and CR plus comorbidity and age for PFS. RS-EBV status had no significant effect on outcome.

Original languageEnglish
Pages (from-to)6005-15
Number of pages11
JournalBlood
Volume119
Issue number25
DOIs
Publication statusPublished - 21 Jun 2012

Keywords / Materials (for Non-textual outputs)

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Clinical Trials, Phase II as Topic
  • Cohort Studies
  • Comorbidity
  • Female
  • Hodgkin Disease
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Survival Analysis
  • Treatment Outcome

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