{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:38:42Z","timestamp":1788385122268,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,2,3]],"date-time":"2020-02-03T00:00:00Z","timestamp":1580688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The clinical management of older adult patients with Hodgkin lymphoma (HL) remains a major challenge. The aim of this study was to evaluate the impact of comorbidity assessment according to a standardized approach, the Cumulative Illness Rating Scale (CIRS), on prognosis in patients with classical HL aged 60\u2009years and older. We studied 76 consecutive older adult patients with HL (median age 69\u2009y, range 60\u201084) who had been treated in our institution between 1999 and 2018. Comorbidity was assessed at diagnosis according to CIRS. Anthracycline\u2010containing chemotherapy with curative intent was administered in 59 (78%) patients. We identified 41 (54%) patients with at least one severe comorbidity rated on CIRS grade\u2009\u2265\u20093. Patients with severe comorbidity were more likely to have advanced\u2010stage disease (\n                    <jats:italic>P<\/jats:italic>\n                    = .003), to have an International Prognostic Score (IPS)\u2009&gt;\u20093 (\n                    <jats:italic>P<\/jats:italic>\n                    = .03), and to not receive anthracycline\u2010containing chemotherapy (\n                    <jats:italic>P<\/jats:italic>\n                    = .008). The probability of overall survival (OS) at 3\u2009years was 88% (95% CI, 71%\u201095%) in patients without severe comorbidities, while it was only 46% (95% CI, 29%\u201062%) in patients with a comorbidity CIRS grade\u2009\u2265\u20093 (\n                    <jats:italic>P<\/jats:italic>\n                    = .0001). The impact of comorbidity on prognosis was also evident when restricting the analysis to patients treated with anthracycline\u2010containing therapy. The 3\u2010year OS was 93% (95% CI, 76%\u201098%) (\n                    <jats:italic>P<\/jats:italic>\n                    = .004) in patients without severe comorbidity and 72% (95% CI, 47%\u201087%) in patients with severe comorbidity (\n                    <jats:italic>P<\/jats:italic>\n                    = .004). In a multivariate analysis, presence of comorbidity, but not age, was a significant factor for OS. Therefore, we conclude that a significant proportion of older adult patients with HL has severe comorbidity on the CIRS scale, which impacts more importantly than age on prognosis.\n                  <\/jats:p>","DOI":"10.1002\/hon.2715","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T23:38:50Z","timestamp":1579304330000},"page":"153-161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Comorbidity assessment to determine prognosis in older adult patients with classical Hodgkin lymphoma"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-916X","authenticated-orcid":false,"given":"Eugenio","family":"Galli","sequence":"first","affiliation":[{"name":"Istituto di Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annarosa","family":"Cuccaro","sequence":"additional","affiliation":[{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Maiolo","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bellesi","sequence":"additional","affiliation":[{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"D'Al\u00f2","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Fusco","sequence":"additional","affiliation":[{"name":"Area Invecchiamento, Ortopedia e Riabilitazione Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Colloca","sequence":"additional","affiliation":[{"name":"Istituto di Geriatria Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Area Invecchiamento, Ortopedia e Riabilitazione Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"De Stefano","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hohaus","sequence":"additional","affiliation":[{"name":"Istituto di Ematologia Universit\u00e0 Cattolica del Sacro Cuore  Rome Italy"},{"name":"Area di Ematologia Fondazione Policlinico Universitario A. Gemelli, IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.4084\/mjhid.2014.050"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2018.1522435"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-08-302604"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-09-378414"},{"issue":"4","key":"e_1_2_7_6_1","first-page":"438","article-title":"Hodgkin's lymphoma in the elderly with special reference to type and intensity of chemotherapy in relation to prognosis","volume":"88","author":"Landgren O","year":"2003","journal-title":"Haematologica"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2019.1608529"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2015.12.002"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28509"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2017.07.005"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2015.10.183"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2014.11.004"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2014.953142"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408648"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1510093"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2005.01.010"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-12-396556"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199811193392104"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2015.355"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.020406"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2010.02.022"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.13904"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.120.2.617"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2012.684347"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61469-0"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-11-681064"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1708984"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.79.0139"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-06-787200"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15741"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00315"}],"container-title":["Hematological Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fhon.2715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hon.2715","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hon.2715","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hon.2715","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,3]],"date-time":"2023-09-03T09:20:11Z","timestamp":1693732811000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hon.2715"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,3]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1002\/hon.2715"],"URL":"https:\/\/doi.org\/10.1002\/hon.2715","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1002\/HON.2715\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/HON.2715\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/HON.2715\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1002\/HON.2715\/v1\/review1","asserted-by":"object"}]},"ISSN":["0278-0232","1099-1069"],"issn-type":[{"value":"0278-0232","type":"print"},{"value":"1099-1069","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,3]]},"assertion":[{"value":"2019-11-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-01-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}