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Annals of Oncology 15:123-128, 2004
© 2004 European Society for Medical Oncology

Original Paper

VEPEMB in elderly Hodgkin’s lymphoma patients. Results from an Intergruppo Italiano Linfomi (IIL) study

Received 26 March 2003; revised 2 July 2003; accepted 18 August 2003

Background:

In advanced age the prognosis of Hodgkin’s lymphoma (HL) is poor, but, as a consequence of the low incidence of HL in the elderly, prospective studies are lacking and the best treatment strategy is difficult to define.

Patients and methods:

One-hundred and five HL patients over 65 years of age were treated homogeneously with an original reduced-intensity regimen designed for HL in the elderly containing vinblastine, cyclophosphamide, procarbazine, etoposide, mitoxantrone and bleomycin (VEPEMB). Forty-eight early stage (IA–IIA) patients received three courses of VEPEMB followed by involved field irradiation. Fifty-seven advanced stage (IIB–IV) patients received six courses followed by radiotherapy limited to the areas of bulky disease.

Results:

Mean age was 71 years (range 66–83). Co-morbidities were present in 39 patients (37%). A treatment plan modification for poor tolerance or toxicity was needed in 18 patients. Results were satisfactory, even if they were better in early rather than in advanced stage disease: complete response rate 98% versus 58% (P <0.01); 5-year failure-free survival 79% versus 34% (P <0.01). The results were affected by advanced stage, systemic symptoms and co-morbidity but they were not influenced by age itself.

Conclusions:

VEPEMB is an effective and low toxic regimen for HL in the elderly. Co-morbidity is a prognostic factor more important than age itself.

A. Levis1,*, A. P. Anselmo2, A. Ambrosetti3, F. Adamo4, M. Bertini5, E. Cavalieri2, P. Gavarotti6, A. Genua7, M. Liberati7, V. Pavone8, D. Pietrasanta1, M. M. Ricetti3, D. R. Scalabrini9, F. Salvi1, U. Vitolo5, E. Angelucci4, M. Boccadoro6, E. Gallo5 and F. Mandelli2

1 Haematology Division of the Ospedale SS Antonio e Biagio, Alessandria; 2 Haematology Division of the University La Sapienza, Roma; 3 Haematology Division of the University of Verona; 4 Haematology Division of the Ospedale Businco, Cagliari; 5 Haematology Division of the Ospedale S Giovanni Battista, Torino; 6 Haematology Division of the University of Torino; 7 Internal Medicine Division of the University of Perugia; 8 Haematology Division of the University of Bari; 9 Institute of Research Against Cancer, Candiolo, Italy

Key words: chemotherapy, co-morbidity, elderly, Hodgkin’s lymphoma, prognosis


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