Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

• Published in: Blood 2012-01, Vol.119 (4), p.990-996
• Main Authors: Sjöberg, Jan, Halthur, Cat, Kristinsson, Sigurdur Y., Landgren, Ola, Axdorph Nygell, Ulla, Dickman, Paul W., Björkholm, Magnus
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Child; Child, Preschool; Female; Follow-Up Studies; Hematologic and hematopoietic diseases; Hodgkin Disease - diagnosis; Hodgkin Disease - mortality; Hodgkin Disease - physiopathology; Hodgkin Disease - therapy; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Prognosis; Registries; Severity of Illness Index; Stem Cell Transplantation - trends; Survival Analysis; Sweden; Young Adult
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2010-08-302604

In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N = 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 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 51-65 years of age (P < .0005). 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 10-year relative survival for patients diagnosed in 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. Therefore, despite progress, age at diagnosis remains an important prognostic factor (P < .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 HL patients still do poorly, and targeted treatment options associated with fewer side effects will advance the clinical HL field.