Parental longevity and survival in elderly patients with Hodgkin's lymphoma

Abstract

BACKGROUND AND OBJECTIVES: In general, elderly patients with Hodgkin's lymphoma (HL) have a less favorable prognosis than younger patients. Factors such as inadequate therapy often due to decreased tolerance to treatment, presence of intercurrent diseases and accumulation of certain clinical and biological risk factors contribute to the poor outcome. Established predictors of prognosis in HL are less appropriate in the elderly population. Consequently, there is a need for additional markers to guide treatment decisions and to improve prediction of outcome. In the general population, the expected length of life of an individual is intimately associated with that of his/her parents. In a small cohort of elderly HL patients, we had previously observed high familial life-span of two previous generations predicts superior survival. The aim of this study was to test the hypothesis that parental longevity alone--an easily accessible and non-disease associated variable--is also associated with improved outcome using an enlarged series of elderly HL patients. DESIGN AND METHODS: One hundred and twenty-one patients with HL >60 years at diagnosis were included. The median follow-up time was 67 (range 37-175) months. Data regarding age at death and reported cause of death were available through parish offices for 228 (94%) parents. The effect of parental lifespan on HL survival included the use of Kaplan-Meier curves and Cox' proportional hazards regression analysis. RESULTS. Maternal as well as paternal lifespan correlated poorly with HL survival, both with regard to overall and disease-specific survival. There was, however, a tendency towards a decreased risk of dying among patients with low maternal lifespan (all-cause mortality: RR=0.7, 95% CI 0.5-1.0). INTERPRETATION AND CONCLUSIONS: Parental longevity does not predict superior survival in elderly patients with HL.