Abstract
Classical Hodgkin's lymphoma (HL) is an aggressive lymphoproliferation with a typical histological finding, in which lymphatic tissue contains so-called Hodgkin's and Reed-Sternberg (RS) cells, on a reactive background composed of a mixture of cells. The disease has 2 peaks in the 30s and 60s with a median age of 43y at the time of diagnosis.
In younger patients, lymphoma can be cured at this time in 65-90% of patients depending on the clinical stage. On the other hand, the prognosis of the elderly patients is significantly worse, which is due to the different biological behavior of lymphoma in old age; the advanced stage is present more common.
Optimal treatment of elderly patients with HL is not yet defined due to the frequent presence of comorbidities in patients and poor tolerance of chemotherapy and / or radiotherapy. A major challenge in the management of elderly patients is finding optimal balance between treatment efficacy and risk of toxicity.
New drugs - targeted therapy (brentuximab vedotine) and immunotherapy (immune checkpoint inhibitors) - have shown significant efficacy in monotherapy and in combination with chemotherapy in the elderly, both in relapse and induction therapy. These new drugs are tested in randomized controlled trials for this subgroup of pts in order to improve their outcome.