Nodular type of lymphocyte predominant Hodgkin’s disease. A clinical study of 50 cases

Pappa, Vassiliki; Norton, A. J.; Gupta, Rajnish K.; Wilson, Alexander; Rohatiner, A. Z. S.; Lister, T. A.

doi:10.1093/oxfordjournals.annonc.a059244

Cited by 50 publications

(19 citation statements)

References 21 publications

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“…21 Although some groups 6,8,18 have observed late recurrences in patients with nodular LPHD, other groups [22][23][24] have not. In the current study, the histologic subtype of LPHD was not specified in 21% of patients; in addition, diffuse architecture was confirmed in only 4% of patients (Table 1).…”

Section: Discussionmentioning

confidence: 99%

European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

Wilder

Schlembach

Jones

et al. 2002

Cancer

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BACKGROUNDLymphocyte‐predominant Hodgkin disease (LPHD) is rare and has a natural history different from that of classic Hodgkin disease. There is little information in the literature regarding the role of chemotherapy in patients with early‐stage LPHD. The objective of this study was to examine recurrence free survival (RFS), overall survival (OS), and patterns of first recurrence in patients with LPHD who were treated with radiotherapy alone or with chemotherapy followed by radiotherapy.METHODSFrom 1963 to 1996, 48 consecutive patients ages 16–49 years (median, 28 years) with Ann Arbor Stage I (n = 30 patients) or Stage II (n = 18 patients), very favorable (VF; n = 5 patients) or favorable (F; n = 43 patients) LPHD, according to the European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte (EORTC‐GELA) criteria, received radiotherapy alone (n = 37 patients) or received chemotherapy followed by radiotherapy (n = 11 patients). The percentages of patients with VF disease (11% vs. 9% in the radiotherapy group vs. the chemotherapy plus radiotherapy group, respectively) or F disease (89% vs. 91%, respectively) within the two treatment groups were similar (P = 1.00). A median of three cycles of chemotherapy with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) or with mitoxantrone, vincristine, vinblastine, and prednisone (NOVP) was given initially to six patients and five patients, respectively. A median total radiotherapy dose of 40 grays (Gy) given in daily fractions of 2.0 Gy was delivered to both treatment groups.RESULTSThe median follow‐up was 9.3 years, and 98% of patients were observed for ≥ 3.0 years. RFS was similar for patients who were treated with radiotherapy alone and patients who were treated with chemotherapy followed by radiotherapy (10‐year survival rates: 77% and 68%, respectively; P = 0.89). The OS rate also was similar for the two groups (10‐year survival rates: 90% and 100%, respectively; P = 0.43). MOPP or NOVP chemotherapy did not reduce the risk of recurrence outside of the radiotherapy fields.CONCLUSIONSMOPP or NOVP chemotherapy did not improve RFS or OS significantly in patients with VF or F LPHD, although the statistical power was limited. Ongoing clinical trials will help to clarify the role of a watch‐and‐wait strategy or systemic therapy, including anthracycline (epirubicin or doxorubicin), bleomycin, and vinblastine‐based chemotherapy or antibody‐based approaches, in the treatment of these patients. Cancer 2002;94:1731–8. © 2002 American Cancer Society.DOI 10.1002/cncr.10404

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Section: Discussionmentioning

confidence: 99%

European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

Wilder

Schlembach

Jones

et al. 2002

Cancer

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“…2,11 To our knowledge to date, few large studies with long-term follow-up have been reported for patients with LPHL who were treated with limited RT alone. 2,6,8,9,[12][13][14][15][16] The objectives of the current study were to examine the long-term results of initial RT alone, to identify favorable patient subsets, and to explore the effect of reducing RT field size on treatment efficacy.…”

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confidence: 99%

Long‐term outcome after radiotherapy alone for lymphocyte‐predominant Hodgkin lymphoma

Wirth

Yuen

Bartoň

et al. 2005

Cancer

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BACKGROUNDThe curative potential of radiotherapy (RT) alone as initial treatment for patients with Stage I–II lymphocyte‐predominant Hodgkin lymphoma (LPHL) has not been defined well.METHODSTwo hundred two patients who were treated between 1969 and 1995 were evaluated in a retrospective, multicenter study.RESULTSPatient characteristics were as follows: The median age was 31 years, 75% of patients were male, 80% of patients had Ann Arbor Stage I disease, 1% of patients had bulky disease, 3% of patients had B symptoms, 1% of patients had extranodal involvement, and 80% of patients had supradiaphragmatic disease. The RT fields were a full mantle field in 52% of patients, less than a full mantle field in 24% of patients, an inverted‐Y field in 17% of patients, less than an inverted‐Y field in 3% of patients, and total lymph node irradiation in 3% of patients. The median dose was 36 Gray. The median follow‐up was 15 years. The overall survival (OS) rate at 15 years was 83%, and freedom from progression (FFP) was observed in 82% of patients, including 84% of patients with Stage I disease and 73% of patients with Stage II disease. No recurrent LPHL and only 1 patient with non‐Hodgkin lymphoma (NHL) were reported after 15 years. Adverse prognostic factors that were identified on multifactor analysis were as follows: for OS, age 45 years or older (P < 0.0005), the presence of B symptoms (P = 0.002), increasing number of sites (P = 0.015); for FFP, increasing number of sites (P = 0.002). No significant difference was found in FFP in a comparison of patients who received elective mediastinal RT with patients who did not receive mediastinal RT (P = 0.11). Causes of death at 15 years were LPHL in 3% of patients, NHL in 2% of patients, in‐field malignancy in 2% of patients, in‐field cardiac/respiratory in 4% of patients, and other in 6% of patients.CONCLUSIONSThe current data suggested that RT potentially may be curative for patients with Stage I–II LPHL and raise the possibility that limited‐field RT may be used without loss of treatment efficacy. Involved‐field RT warrants further investigation for patients with early‐stage LPHL. Cancer 2005. © 2005 American Cancer Society.

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“…About two dozen retrospective series have been published in the last three decades characterizing the clinical features of Ͼ1,500 cases of NLPHL (Table 2) [19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. The reliability of clinical observations in many of the early studies, however, is uncertain, as many included patients that would likely now be reclassified as having lymphocyte-rich classical Hodgkin lymphoma (LRCHL) or other diseases.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…Representative histologies are displayed in Figure 1. Of note, in studies of NLPHL incorporating central pathologic review, up to half the cases were ultimately assigned a different diagnosis, illustrating the difficulty in pathologic interpretation of this disease [19,23,27,30,33,34,41].…”

Section: Histopathologic Featuresmentioning

confidence: 99%

“…In single-institution series, most patients with stage III or IV NLPHL were treated with CM or CMT using MOPP-like, ABVD-like, or hybrid CM regimens (Table 3) [26,27,33]. One study from the U.K. showed a clear decrement in CR rate as a function of stage, with no impact of stage on remission duration or OS [27], whereas the ETFL study reported a negative impact of stage on both FFTF and OS [33]. In general, our understanding of advanced stage NLPHL is poor, and better treatment options are needed for such patients.…”

Section: Advanced Stage Diseasementioning

confidence: 99%

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Nodular Lymphocyte Predominant Hodgkin Lymphoma

Lee

LaCasce

2009

The Oncologist

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Nodular type of lymphocyte predominant Hodgkin’s disease. A clinical study of 50 cases

Cited by 50 publications

References 21 publications

European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

Long‐term outcome after radiotherapy alone for lymphocyte‐predominant Hodgkin lymphoma

Nodular Lymphocyte Predominant Hodgkin Lymphoma

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