The outcome of older adults with classic Hodgkin lymphoma in British Columbia.

Outcomes in older adults with classical Hodgkin lymphoma (cHL) have traditionally been poor, in part related to poor tolerance to standard chemotherapy. Herein, we evaluated the survival of patients aged >60 years with cHL in British Columbia in a population-based analysis. From 1961 to 2019, 744 pa-tients with newly diagnosed cHL were identified. With a median follow-up of 9 years, 5-year disease specific (DSS) and overall survival (OS) have improved by decade comparison (both p<0.001), remain-ing stable in the past 20 years (DSS p=0.35; OS p=0.26). In the modern management era (2000-present), 361/401 patients (90%) received active therapy for cHL and had a 5-year OS of 60%. For those who received curative intent therapy (n=327), the 5-year progression-free survival (PFS), OS and DSS were 60%, 65%, and 76%, respectively and estimates were superior in those 60-69 y (72%, 77%, 83%) compared with those 70-79 y (54%, 57%, 70%) and >80 (28%, 39%, 63%) (p<0.05 for all). Overall, pul-monary toxicity occurred in 58/279 (21%) of bleomycin-treated patients, with 22/58 (38%) occurring after cycles 1 or 2, accounting for 8/20 (40%) of treatment-related deaths. Outcomes in older adults with cHL have improved in recent decades however, they remain poor for those >70 even in the mod-ern treatment era. Further, treatment-related toxicity remains a significant concern and use of bleo-mycin should be avoided in most patients.