Hodgkin’s Lymphoma: An Environmental Scan
Table of Contents
4.6 A Note on Special Populations:
4.6.1 Older Adults
A particular group among all individuals with HL are older adults (age 60 and over), who are diagnosed with HL. Individuals above age 60 have the poorest prognostic outcomes among all HL patients. It is thought that the overall estimation of the rates of HL among older adults is underestimated and that many individuals will die prior to diagnosis. Interestingly, Boll and colleagues suggest that the bimodal distribution of HL (after age 55) is no longer observed, one reason being a majority of these individuals are actually diagnosed with a type of non-Hodgkin’s lymphoma. This group fairs the poorest among all HL patients in terms of the complications, ability to tolerate and the toxicity of conventional treatments among other detrimental outcomes (Klimm, Diehl, and Andreas Engert 2007).
More research into particular interventions for this group is required as the majority of oldest HL patients are not included in clinical trials, thus outcomes found from current clinical trial research do not necessarily apply to this group. As the demographic trend continues toward a larger population base of older adults, it is suggested that research focus on continued new drug therapies for this particular group to address the growing demand of patients expected in the future.
4.6.2 Patients with Complications or Late Effects
As the incidence of HL continues to increase and our population ages, there is no reason to believe at this juxtaposition that the rates of lymphoma and specifically HL will decrease. Therefore, more people will be diagnosed with this form of cancer and undergo treatment to curb their disease. Additionally, the occurrence of HL among younger adults suggests that the issue of late effects or complications due to conventional treatment will continue. Priorities already noted such as primary prevention through diet and vaccines along with the development of personalized medicine will dramatically reduce the burden of illness associated with late effects. It is wholly important to address the risk of cardiovascular disease and the development of secondary cancers associated with treatments if we are to make the next major gain in the area of HL. Given such a large majority of individuals are successfully treated with current therapies, reducing the morbidity and mortality for those having already suffered from HL is an important consideration.