Hodgkin's Disease in Northern Sweden 1971-1981. III. The Clinical and Prognostic Impact of Age

A Swedish national care programme has provided guidelines for staging, treatment and follow‐up of all patients with Hodgkin's disease (HD) since 1985. Between January 1985 and December 1992, 920 patients were reported and followed prospectively. Of a total of 533 patients with stage I and II disease, 484 presented with supradiaphragmatic HD and 49 (9%) with infradiaphragmatic HD. The median follow‐up time was 4.3 yr (3.3–10 yr). Significant differences in average age (45±21 yr and 55±19 yr), male: female ratio (1.1 : 1 and 2.8 : 1) and B‐symptoms (25% and 47%) were observed in patients with supra‐ and infradiaphragmatic HD, respectively. Forty‐six patients with infradiaphragmatic HD were treated with a curative intention and 40 (87%) achieved a complete response. Eleven (28%) of the 40 patients have recurred and 8 patients have died of HD. Complete response rates and recurrence frequencies did not differ from those observed in patients with supradiaphragmatic HD. Mortality was, however, significantly higher (p=0.001) in the infradiaphragmatic group; this was due mainly to poorer effects of salvage treatment in an elderly population. In this population‐based study, patients with peripheral disease in stage IA respond well to inverted Y irradiation alone, whereas it appears to be important to give stage II patients chemotherapy or a combined modality treatment in order to avoid unacceptably high recurrence rates.

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Infradiaphragmatic Hodgkin's disease: the Swedish National Care Programme experience

Kälkner

Enblad

Gustavsson

et al. 1997

European J of Haematology

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Non-Hodgkin'S Lymphoma in Northern Sweden Prognostic Factors and Response to Treatment

et al. 1993

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A total of 352 cases of non-Hodgkin's lymphoma reported to the Cancer Registry of Northern Sweden during 1978-1982 were retrospectively analysed. After morphologic review, 327 cases classifiable as low (n = 162) or high-grade (n = 165) according to the Kiel classification remained for further study. The purpose of the study was to evaluate the interrelations between some variables and their bearing on prognosis in an almost unselected clinical material. Age, morphological grade of malignancy, clinical stage, systemic symptoms, bulk of disease and serum lactate dehydrogenase (LDH) level turned out to be associated with the clinical outcome in terms of response to treatment, disease-free survival and survival. In the heterogenous group of low-grade lymphoma, six pretreatment characteristics were negatively associated with survival in a univariate analysis, namely; stage II-IV, systemic symptoms, bone marrow infiltration, two or more extranodal sites, elevated LDH and age above 65 years. In high-grade lymphoma, stage II-IV, bone marrow infiltration and elevated LDH predicted a worse prognosis in a multivariate analysis. The impact of the number of these prognostic factors on survival in high-grade lymphoma was demonstrated.

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Hodgkin's Disease in Young and Elderly Patients. Clinical and Pathological Studies

Enblad

1994

Upsala Journal of Medical Sciences

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Hodgkin's Disease in Northern Sweden 1971-1981. III. The Clinical and Prognostic Impact of Age

Cited by 5 publications

References 9 publications

Infradiaphragmatic Hodgkin's disease: the Swedish National Care Programme experience

Infradiaphragmatic Hodgkin's disease: the Swedish National Care Programme experience

Non-Hodgkin'S Lymphoma in Northern Sweden Prognostic Factors and Response to Treatment

Hodgkin's Disease in Young and Elderly Patients. Clinical and Pathological Studies

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