title: VEPEMB in elderly Hodgkin's lymphoma patients. Results from an Intergruppo Italiano Linfomi (IIL) study.
abstract: 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.
  
  
  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.
authors.affiliation: Haematology Division of the Ospedale SS Antonio e Biagio, Alessandria, Italy. alevis@ospedale.al.it
authors.forename: A
authors.initials: A
authors.lastname: Levis
authors.forename: A P
authors.initials: AP
authors.lastname: Anselmo
authors.forename: A
authors.initials: A
authors.lastname: Ambrosetti
authors.forename: F
authors.initials: F
authors.lastname: Adamo
authors.forename: M
authors.initials: M
authors.lastname: Bertini
authors.forename: E
authors.initials: E
authors.lastname: Cavalieri
authors.forename: P
authors.initials: P
authors.lastname: Gavarotti
authors.forename: A
authors.initials: A
authors.lastname: Genua
authors.forename: M
authors.initials: M
authors.lastname: Liberati
authors.forename: V
authors.initials: V
authors.lastname: Pavone
authors.forename: D
authors.initials: D
authors.lastname: Pietrasanta
authors.forename: M M
authors.initials: MM
authors.lastname: Ricetti
authors.forename: D R
authors.initials: DR
authors.lastname: Scalabrini
authors.forename: F
authors.initials: F
authors.lastname: Salvi
authors.forename: U
authors.initials: U
authors.lastname: Vitolo
authors.forename: E
authors.initials: E
authors.lastname: Angelucci
authors.forename: M
authors.initials: M
authors.lastname: Boccadoro
authors.forename: E
authors.initials: E
authors.lastname: Gallo
authors.forename: F
authors.initials: F
authors.lastname: Mandelli
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D015897:Comorbidity; D003520:Cyclophosphamide / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D006801:Humans; D007558:Italy; D008297:Male; D008942:Mitoxantrone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011379:Prognosis; D011446:Prospective Studies; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014747:Vinblastine; D005047:Etoposide; D003520:Cyclophosphamide; D008942:Mitoxantrone