Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden 1973-2009
Cette étude en population suédoise analyse l'évolution de la morbidité et de la survie de patients atteints de lymphome hodgkinien, sur la période 1973-2009
During recent decades attention has focused on reducing long-term treatment-related morbidity and mortality in Hodgkin lymphoma (HL). We studied trends in relative survival for all patients diagnosed with HL in Sweden 1973-2009 (n=6,949; 3,985 men and 2,964 women; median age 45 years) and followed up for death until the end of 2010. Patients were categorized into six age groups and five calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009). Relative survival improved in all age groups with the greatest improvement in patients aged 51-65 years (p<0.0005). Importantly, a plateau in relative survival was observed in patients below 65 years of age during the last calendar period, suggesting a reduced long-term treatment-related mortality. The ten-year relative survival for patients diagnosed 2000-2009 was 0.95, 0.96, 0.93, 0.80, and 0.44 for the age groups 0-18, 19-35, 36-50, 51-65, and 66-80, respectively. Thus, despite progress, age at diagnosis remains an important prognostic factor (p<0.0005). Advances in therapy for patients with limited and advanced-stage HL have contributed to an increasing cure rate. In addition, our findings support that long-term mortality of HL therapy has decreased. Elderly patients still do poorly and targeted treatment options associated with fewer side effects will advance the clinical HL field.