Yazarlar : Proctor SJ, Wilkinson J, Jones G, Watson GC, Lucraft HH, Mainou-Fowler T, Culligan D, Galloway MJ, Wood KM, McNally RJ, James PW, Goodlad JR

Yayın : Blood

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22577177

Konu : Geriyatrik Hematoloji

Literatür İçeriği :  

Abstract

The SHIELD programme for Hodgkin lymphoma in patients aged ≥ 60 years, prospectively evaluated clinical features and outcome in a large patient cohort (n=175). The central element was a Phase II study of VEPEMB chemotherapy (n=103, median age 73 years) incorporating co-morbidity assessment. 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 x3 + radiotherapy. Median follow-up was 36 months. CR rate (ITT) was 74% and 3-year overall survival (OS) and progression-free survival (PFS) were 81% and 74% respectively. 72 patients had advanced stage disease (stage 1B/2B/3 or 4) and received VEPEMB x6. 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 co-morbidity and age for PFS. RS- EBV status had no significant effect on outcome.

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