Dr Alison Moskowitz Discusses Survival Disparities in Hodgkin Lymphoma

Patients who are over 60 with Hodgkin lymphoma have much lower survival rates than patients who are under 60, explained Alison J. Moskowitz, MD, medical oncologist, clinical director, lymphoma inpatient unit, Memorial Sloan Kettering Cancer Center.

TranscriptAre there any disparities in survival among patients with Hodkgin lymphoma?

There are disparities with regard to survival. Patients who are over 60 with Hodgkin lymphoma have much lower survival than patients who are under 60, and that has been found partly because the biology of the disease may be a little different, but the major reason is because of reduced tolerability to treatment and more toxicity related to treatment and likely also due to more comorbidities.

So, our treatment for patients who are over 60 tends to be modified a little bit. One of the things we really try to be careful with those patients is exposing them to bleomycin because they do have a higher chance of having bleomycin lung toxicity. So, one approach could be to try to still expose them to bleomycin but try and reduce it as much as possible, which is possible if we use the approach where patients receive 2 cycles of regular ABVD [doxorubicin, bleomycin, vinblastine and darcarbacine] chemotherapy and if they have a PET [positron emission tomography]-negative response then we drop bleomycin for further treatment. For some patients we really want to try to avoid bleomycin all together. It’s not unreasonable to give them just AVD chemotherapy without the bleomycin. It’s probably associated with a less favorable outcome but still could be curable.