Clinical Dilemmas in the Treatment of Elderly Patients Suffering from Hodgkin Lymphoma: A Review

Znanstveni rad - Pregledni rad

• Autor: Vibor Milunović
• Autor: Ida Hude
• Autor: Goran Rinčić
• Autor: Davor Galušić
• Autor: Aron Grubešić
• Autor: Marko Martinović
• Autor: Nika Popović
• Autor: Sunčana Divošević
• Autor: Klara Brčić
• Autor: Marin Međugorac
• Autor: Luka Kužat
• Autor: Dejan Strahija
• Autor: Stefan Mrđenović
• Autor: Inga Mandac Smoljanović
• Autor: Delfa Radić-Krišto
• Autor: Slavko Gašparov
• Autor: Igor Aurer
• Autor: Slobodanka Ostojić Kolonić
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA INTERNU MEDICINU)
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA PATOLOGIJU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Interna medicina
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Patologija

Sažetak (engleski)

Elderly patients make up a significant number of cases of newly diagnosed Hodgkin lymphoma. However, unlike in young patients, the outcomes of elderly patients are poor, and they are under-represented in phase III trials. Prior to treatment initiation, geriatric assessment should ideally be performed to address the patient’s fitness and decide whether to pursue a curative or palliative approach. The ABVD regimen is poorly tolerated in unfit patients, with high treatment-related mortality. Alternative chemotherapy approaches have been explored, with mixed results obtained concerning their feasibility and toxicity in phase II trials. The introduction of brentuximab vedotin-based regimens led to a paradigm shift in first- and further-line treatment of elderly Hodgkin lymphoma patients, providing adequate disease control within a broader patient population. As far as checkpoint inhibitors are concerned, we are only just beginning to understand the role in the treatment of this population. In relapsed/refractory settings there are few options, ranging from autologous stem cell transplantation in selected patients to pembrolizumab, but unfortunately, palliative care is the most common modality. Importantly, published studies are frequently burdened with numerous biases (such as low numbers of patients, selection bias and lack of geriatric assessment), leading to low level of evidence. Furthermore, there are few ongoing studies on this topic. Thus, elderly Hodgkin lymphoma patients are hard to treat and represent an unmet need in hematologic oncology. In conclusion, treatment needs to be personalized and tailored on a case-by-case basis. In this article, we outline treatment options for elderly Hodgkin lymphoma patients.

• Ključne riječi (engleski): ABVD protocol; Hodgkin lymphoma; brentuximab vedotin; frail elderly; geriatric assessment; immune checkpoint inhibitors
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Pregledni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Biomedicines
• Brojčani podaci: vol. 10, br. 11, 2917
• e-ISSN: 2227-9059
• DOI: https://doi.org/10.3390/biomedicines10112917
• URN:NBN: urn:nbn:hr:105:119630
• Datum objave publikacije: 2022-11-14
• URL dokumenta: https://www.mdpi.com/2227-9059/10/11/2917
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2023-06-19 07:35:48