Biology, Clinical Course and Management of Nodular Lymphocyte-Predominant Hodgkin Lymphoma

Nogová, Lucia; Rüdiger, Thomas; Engert, Andreas

doi:10.1182/asheducation-2006.1.266

Cited by 46 publications

(37 citation statements)

References 36 publications

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“…As has been described in other studies [8][9][10] , we found an ongoing risk of evolution to high-grade NHL.…”

Section: Discussionsupporting

confidence: 70%

“…11 It is being increasingly recognised that late toxicity with such treatments is substantial; excess risk of second cancers and cardiovascular disease continues to rise long after treatment and even 30 years after diagnosis, HL patients continue to have an elevated risk of death from all causes. 12 In spite of this, some groups argue for treatment intensification 8,13 reporting improved responses, without improvements in overall survival.…”

Section: Introductionmentioning

confidence: 99%

“…This risk of transformation, often long after the initial diagnosis, has been confirmed in previous studies. [5][6][7] Previous retrospective studies have examined the presentation of NLPHL [8][9][10] , however, due to its rarity and low incidence of events, there have been no published prospective randomised controlled trials in this area, outwith the context of NLPHL cases included in larger cHL trials. As a result, there is widespread variation worldwide in treatment of this condition.…”

Section: Introductionmentioning

confidence: 99%

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Nodular lymphocyte predominant Hodgkin lymphoma behaves as a distinct clinical entity with good outcome: evidence from 14-year follow-up in the West of Scotland Cancer Network

Farrell

McKay

Leach

2011

Leukemia & Lymphoma

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Clinically and biologically, nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) has much more in common with germinal-centre derived B-cell NHL than classical HL. Management of NLPHL remains controversial. In a 14-year multi-centre series, 69 cases were analysed; median follow-up was 53 months (range 11-165.) B symptoms were present in only 4.3% of patients. 81.1% of patients had stage I/II disease. Treatment was with radiotherapy (53.6 %), chemotherapy (21.7%), combined modality (17.4%) and observation (7.2%.) 10.1% of patients relapsed and 2.9% of patients developed high-grade transformation to DLBCL. All relapses and transformations were salvageable. No patient died of their disease. The 5 yr relapse-free survival was 96.7%, transformation-free survival 98.4% and overall survival 100%. We conclude that NLPHL behaves as a distinct clinical entity, often presenting at early stage without risk factors. It has an excellent outcome. It may be possible to reduce intensity of therapy in NLPHL without affecting OS.

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“…As has been described in other studies [8][9][10] , we found an ongoing risk of evolution to high-grade NHL.…”

Section: Discussionsupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Nodular lymphocyte predominant Hodgkin lymphoma behaves as a distinct clinical entity with good outcome: evidence from 14-year follow-up in the West of Scotland Cancer Network

Farrell

McKay

Leach

2011

Leukemia & Lymphoma

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“…When compared with classical HL (cHL), NLPHL is characterized by a more indolent clinical course often resembling indolent B cell non-Hodgkin lymphoma (NHL) and a substantially different immunophenotype with consistent positivity for CD20 [31,32]. Due to its mostly indolent clinical course, the standard treatment for early favorable NLPHL recommended by most cooperative groups consists of RT alone [33,34].…”

Section: Treatment Of Nodular Lymphocyte-predominant Hl (Nlphl)mentioning

confidence: 99%

Advances in the treatment of Hodgkin lymphoma

Eichenauer

Engert

2012

Int J Hematol

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In the past decades, Hodgkin lymphoma (HL) has turned from an incurable disease to one with the most favorable prognosis among adult malignancies. This is due to the introduction of effective multi-agent chemotherapy and the optimization of radiation techniques. At present, 80-90 % of patients achieve long-term remission when receiving appropriate first-line treatment. Even in case of relapse, up to 50 % can be successfully salvaged with highdose chemotherapy and autologous stem cell transplantation. Thus, current studies do not necessarily aim at increasing treatment efficacy but rather focus on a possible reduction of acute and late toxicity by decreasing treatment intensity if possible. One promising strategy to spare therapy in good-risk patients is early response-adapted treatment stratification according to the result of interim positron emission tomography. The evaluation of novel drugs and the optimization of treatment for elderly HL patients and those with nodular lymphocyte-predominant HL are further aspects that are currently being addressed in ongoing trials. This review will give an overview on more recent clinical trials and discuss possible future strategies for the treatment of HL.

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“…Recurrences of cHL usually show features of cHL, whereas recurrences of NLPHL can show either NLPHL or transformation to a large B cell lymphoma. In approximately 3-7% patients with NLPHL, concurrent or subsequent transformation to a diffuse large B cell lymphoma (DLBCL) is observed [1][2][3][4]. A clonal relationship has been demonstrated between the LP cells of NLPHL and the neoplastic large B cells of the associated DLBCL by molecular genetics [1,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Small intestinal presentation of nodular lymphocyte-predominant Hodgkin lymphoma with T cell/histiocyte-rich B cell lymphoma-like areas—with review of literature on extranodal presentation of this disease

et al. 2010

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Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), accounts for ∼5% of all cases of Hodgkin lymphoma and is characterized by involvement of the peripheral lymph nodes. NLPHL occurs in young adults and is associated with frequent relapses. In 3% to 7% of cases, NLPHL progresses to a diffuse large B cell lymphoma. Furthermore, a proportion of NLPHL also have areas with features of T cell/histiocyte-rich large B cell lymphoma (THRLBCL), either at presentation or on follow-up. Here, we describe a 32-year-old man who presented to the emergency department with small bowel perforation. The resected small bowel showed fullthickness mural ulceration and involvement by a lymphoma with features of NLPHL that also had areas resembling THRLBCL. The patient had axillary lymphadenopathy, biopsy of which showed NLPHL with focal THRLBCLlike areas. Such a lymphoma presenting as small intestinal lesion/perforation has not been reported in the literature before. We take this opportunity to review the literature on extranodal presentations of NLPHL and discuss the natural history of this disease.

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Biology, Clinical Course and Management of Nodular Lymphocyte-Predominant Hodgkin Lymphoma

Cited by 46 publications

References 36 publications

Nodular lymphocyte predominant Hodgkin lymphoma behaves as a distinct clinical entity with good outcome: evidence from 14-year follow-up in the West of Scotland Cancer Network

Nodular lymphocyte predominant Hodgkin lymphoma behaves as a distinct clinical entity with good outcome: evidence from 14-year follow-up in the West of Scotland Cancer Network

Advances in the treatment of Hodgkin lymphoma

Small intestinal presentation of nodular lymphocyte-predominant Hodgkin lymphoma with T cell/histiocyte-rich B cell lymphoma-like areas—with review of literature on extranodal presentation of this disease

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