Patients above sixty years of age with Hodgkin's lymphoma treated with a new strategy

In the Swedish National Care Programme for Hodgkin's lymphoma (HL) a less intensive chemotherapy regimen with individualized dosing (LVPP/OEPA) was introduced in 1989. In total, 139 patients, 77 between 1985 and 1988 and 62 between 1989 and 1992, were studied. Mean ages were 72 and 71 years, respectively. One hundred and nineteen patients were treated with curative intention, 63 (82%) between 1985 and 1988 vs. 56 (90%) between 1989 and 1992 (p = 0.11). All patients (13 vs. 20) treated with radiotherapy only achieved a complete remission (CR). The CR rates (67% vs. 65%) for patients treated with 6-8 cycles of chemotherapy were also similar in the two time periods. The 5-year survival rate was 45% in the period 1985-1988 and 48% in 1989-1992. The survival of elderly HL patients was thus not improved from 1985-1988 to 1989-1992. Thus efforts to improve the chemotherapy regimen with individualized dosing did not change the outcome. Many patients experienced myelosuppression and opportunistic infections that may have contributed to the poor treatment results.