Changing Patterns in the Clinical Pathological Features of Hodgkin Lymphoma: A Report from Debrecen, Hungary

Abstract

Introduction. Hodgkin lymphoma shows a well-known geographic pattern, but temporal changes have been found recently as well. Patients and Methods. 439 Hodgkin lymphoma patients' clinicopathological and treatment data were processed in calendar periods of approximately ten years. The patients were treated at our department from 1980 until the end of 2008. Results. The first period (1980–89) contained 177 patients, the second (1990–99) 147, and the third (2000–08) 115 Hodgkin lymphoma patients. The mean age of the patients was 40.1, 35.9, and 36.8 years in order. The male/female ratio: 1.42, 1.45, 1.05 in order. Contrary-wise a unimodal age group pattern could have been seen with an incidence peak between 30 and 39 in the past decades. The incidence of classical mixed cellularity histological subtype is decreasing (43.7%, 58.23%, 42.6%, P = 0.0098 (it is only significant in the second period)); classical nodular sclerosis shows an increasing tendency (25%, 27.32%, 34.78%, P = 0.1734). The first incidence peak is predominantly created by classical nodular sclerosis, meanwhile the second peak by classical mixed cellularity. The number of early-stage patients (59.12%) is beyond the advanced stage (40%) in the last decade. Meanwhile, the number of second-stage patients was increasing (25.8%, 26.35%, 49.56% P < 0.0001) and of patients in third stage was decreasing (53.4 %, 50.67%, 20% P < 0.0001). The 5- and 10-year overall survival data were progressing: 59.7 %, 77.4 %, and 90.5 % and 44.1 %, 70.6 % and 90.5 % (expected survival) in the last decade. Conclusions. Changes can be explained by the altered nature of Hodgkin lymphoma, the changes in socioeconomic status and the development of diagnostic and therapy methods.

Overview and outcome of Hodgkin’s Lymphoma: Experience of a single developing country’s oncology centre

“…Similarly, the Surveillance, Epidemiology, and End Results program (SEER), which analysed data of 21,734 HL in the United States, reported figures of 19%, 49%, 19%, and 13% for clinical stages I, II, III, and IV, respectively [ 31 ]. Other studies from Europe have reported similar figures [ 7 , 32 ]. In contrary, at least more than half of HL patients in developing countries are diagnosed with advanced stage disease [ 9 , 10 , 33 , 34 ].…”

How the Epidemiology of Hodgkin Lymphoma Changed in Debrecen, Hungary

“…Pattern 2, seen in countries with transitional economies, has an early childhood peak and a second (female) decade peak with equal frequencies of the cMC and cNS subtypes (Chang, Chen, Jones, & Su, 2008;Landgren & Caporaso, 2007). Considering the changing patterns in the clinical pathological features in HL, the authors regarded worthwhile to investigate, whether the pathological or clinical nature of HL have changed in the past 5 years, since their previous report on this subject (Miltényi et al, 2011).…”