Hodgkin's Disease in the Elderly

Li, FrederickP.; Lokich, Jacob J.; Costanza, Mary E.; Moloney, W. C.; Hellman, Samuel

doi:10.1016/s0140-6736(73)92167-3

Cited by 8 publications

(4 citation statements)

References 5 publications

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“…The most prominent difference is observed in the high incidence of retroperitoneal disease (33 and 84%) in the two series of elderly patients. Furthermore, in a more extensive sample of elderly patients (more than 50 years of age), only 21% of 150 patients had mediastinal tumors and 27% had solely infradiaphragmatic involvement [10]. This distinctive distribution of disease in the elderly has led to speculation with regard to the etiology and pathogenesis of the disease in this group.…”

Section: Discussionmentioning

confidence: 99%

Hodgkin’s Disease in the Elderly

Lokich¹,

Pinkus²,

Moloney³

1974

Oncology

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47 patients with Hodgkin’s disease presenting after age 60 were analyzed retrospectively for clinical presentation, distribution of disease, and histopathology, and compared to a younger control group. The types of clinical presentation included: local or generalized adenopathy, 50%; ‘B’ symptoms, 25%; ‘unusual manifestations’ and intra-abdominal complications, 13%; and incidentally discovered disease, 12%. In contrast, the younger group presented less often for symptoms (p < 0.01) and more often for adenopathy (p < 0.01). Disease distribution was unique in the elderly compared to the young with a higher incidence of inguinal (p < 0.01), splenic (p < 0.01), and gastrointestinal disease (p < 0.01) and a lower indicence of mediastinal disease (p < 0.01). Histopathology in elderly patients revealed more lymphocyte depletion and less nodular sclerosis than the young patients. 38 of 47 elderly patients were classified as stage III or IV compared to 22/47 in the young. 26 elderly and only 9 young patients had ‘B’ symptoms. Survival was compared for pathologically matched stage IV A and B patients, and the median duration was 5 and 40 months for the elderly and young groups, respectively, (p < 0.001). This difference may be a consequence of differences in therapeutic approaches toward the elderly. Hodgkin’s disease has distinctive clinical and pathologic features which characterize the disease in the elderly and are relevant to diagnostic and therapeutic management.

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Section: Discussionmentioning

confidence: 99%

Hodgkin’s Disease in the Elderly

Lokich¹,

Pinkus²,

Moloney³

1974

Oncology

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“…On the contrary, other features of the disease have been elucidated to some extent by studies previously published. As regards histology, mixed cellularity (MC) has been shown to be the histotype more frequently found in the elderly, whereas lymphocyte predominance (LP) seems to pre vail in young patients [7]; eosinophilic infiltrates have proven less frequent in elderly subjects whereas the frequency of atypical mytosis is increased [8], The disease presentation has also been shown to differ depending on the age group: in fact, 25% of geriatric patients have infradiaphragmatic involvement at pre sentation as compared with only 5% in the young [9]; in addition, less than 25% of elderly patients have mediastinal involvement versus more than 50% in young subjects [2,9]. As regards immunology, while aging is known to be associated with progressive T-cell defect in normal subjects [10], a more pronounced agerelated deterioration of T-cell function has been observed in HD patients and this fact has been thought to shorten survival [11,12], By contrast, information presently available on prognosis, survival, disease-free interval after re mission, and side effects of radio-and chemotherapy in elderly subjects is by no means conclusive, although these aspects of the disease are the most significant from a clinical point of view.…”

Section: Introductionmentioning

confidence: 99%

Hodgkin’s Disease in the Elderly : A Retrospective Clinicopathologic Study of 61 Patients Aged over 60 Years

Ferrini¹,

Bosi²,

Casini³

et al. 1987

Acta Haematol

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61 cases of Hodgkin’s disease (HD) with age over sixty years were diagnosed in a series of 387 patients. Mixed cellularity (57.4%) and nodular sclerosis (14.7%) were the most common histologic subtypes. Clinical presentation was characterized by superficial lymphadenopathy (92%) and/or general symptoms (57.4%). Mediastinal involvement was observed in 24.6% of cases, and 24.6% of patients had a primitive infradiaphragmatic presentation. Stage II was the most frequent (47.5%). At the onset of the disease, normal values of hemoglobin and white cells were observed while the platelet count was more variable. Only 3 patients (5%) were given radiotherapy (RT), 3 received chemotherapy (CH) plus RT, and 55 (90%) CH. Severe hematologic toxicity was observed in only 11.1% of cases. Complete remission (CR) was obtained in 37 patients (61%), 10 of whom relapsed. Elderly patients had a 5-year survival rate of 54.9%, while in younger ones it was 76.4% (p < 0.001). Survival was strongly influenced by the achievement of CR (p < 0.001), whereas stage, histopathology, systemic symptoms and therapeutic modalities did not correlate significantly

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“…The anatomical distribution of the disease at diagnosis varies also with age. Twenty-five percent of elderly patients have only infradiaphragmatic lesions at diagnosis, compared with <5% of young adult patients (Li et al, 1973). Furthermore there is marked geographical variation in the age-incidence pattern of HD among the young but not among the elderly, and this variation has been related to socioeconomic factors (Correa & O'Conor, 1971).…”

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confidence: 99%

Epidemiological study of socioeconomic factors and clinical findings in Hodgkin's disease, and reanalysis of previous data regarding chemical exposure

Hardell¹,

Bengtsson²

1983

Br J Cancer

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Summary An association between malignant lymphoma (both Hodgkin's disease (HD) and non-Hodgkin lymphoma) and exposure to organic solvents, phenoxy acids, or chlorophenols was previously reported. A reanalysis of this investigation regarding the cases with HD and exposure to various chemicals was performed and resulted in comparable findings to the whole group of malignant lymphoma. There was an overrepresentation of cases with primary involvement of the gastrointestinal tract which was associated with exposure to these chemicals. The influence of previous diseases and socioeconomic factors was analysed through a supplementary questionnaire to the cases with HD and their matched controls. No differences were found in cases and controls for such variables except for tonsillectomy which was overrepresented among the cases as well as a history of previous duodenal or ventricular ulceration. These findings were, however, insignificant.

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Hodgkin's Disease in the Elderly

Cited by 8 publications

References 5 publications

Hodgkin’s Disease in the Elderly

Hodgkin’s Disease in the Elderly

Hodgkin’s Disease in the Elderly : A Retrospective Clinicopathologic Study of 61 Patients Aged over 60 Years

Epidemiological study of socioeconomic factors and clinical findings in Hodgkin's disease, and reanalysis of previous data regarding chemical exposure

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