Prognostic factors and 5-year overall survival in older adults (≥60 years) with Hodgkin lymphoma in Latin America: A multicenter cohort study

Abstract

Abstract Background: Data on outcomes and prognostic factors in older adults with Hodgkin lymphoma (HL) from Latin America remain scarce. We aimed to characterize overall survival (OS) and identify clinical predictors of 5-year OS in this population. Methods: We analyzed a multicenter cohort of 241 HL patients, treated with ABVD regimen, aged ≥60 years from Latin America. Clinical, laboratory, and treatment variables were harmonized and cleaned for analysis. Five-year OS was estimated using Kaplan-Meier methods. Univariate Cox regression models tested associations between OS and covariates including age, Ann Arbor stage, lymphocyte count, hemoglobin, and PET response. Variables significant in univariate analyses and clinically relevant were included in a multivariable Cox proportional hazards model. Results: Median age was 68 years (range 60–88), with 61% males. The 5-year OS was 65.2% (95% CI: 58.0–73.3%). In univariate analysis, increasing age (HR per year 1.06, p=0.0018), advanced Ann Arbor stage, lymphopenia (<600/mm³ or <8%; HR=0.43, p=0.007), and anemia (Hb <10 g/dL; HR=0.40, p=0.001) were significantly associated with worse OS. PET response was not significantly associated with OS. In the multivariable model (n=154, 38 events), older age (HR 1.08 per year, p=0.0007), advanced Ann Arbor stage (notably stages IIA, IIIA, IIIB; p<0.05), and lymphopenia (HR 0.39, p=0.023) remained independent predictors of inferior 5-year OS. Hemoglobin was not independently significant after adjustment. Conclusions: Older age, advanced disease stage, and low lymphocyte count independently predict poorer survival in older Latin American patients with HL. These factors should be incorporated into risk stratification and management decisions to improve outcomes. Further research is needed to optimize therapies tailored for this population. Keywords: Hodgkin lymphoma, elderly, Latin America, survival, prognostic factors