Therapy of Hodgkin’s lymphoma in clinical practice: A retrospective long-term follow-up analysis

Abstract

Abstract. Treatment of Hodgkin's lymphoma (HL) is perceived to be relatively straightforward. Consequently, patients are not usually referred to hemato-oncologically specialized centres and are treated locally instead. Comprehensive findings beyond prospective controlled trials are therefore lacking. Clinical data of 209 patients who had received a HL diagnosis were collected. A total of 7 patients received radiotherapy (RT) alone (3%), 75 (35%) were treated with a combination of chemotherapy (CT) and RT and 127 patients received CT alone [mainly doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)]. Complete response (CR) following first-line treatment was achieved in 178 patients (85%) and in 195 (93%) after salvage treatment. Favorable disease (p=0.000359), limitedstage disease (p=0.0003), involvement of lymph nodes above the diaphragm (p=0.05) and absence of mediastinal bulky tumor involvement positively affected the CR rate following first-line treatment. Out of the 195 patients that achieved CR, 31 relapsed. Male gender (p=0.043) and age over 45 years (p=0.047) were significantly associated with an increased incidence of relapse. Age at diagnosis was the key factor affecting long-term outcome. The event-free survival (EFS) projected at 120 months was 80 and 57% for patients younger and older than 45 years, respectively (p=0.022). The overall survival (OS) projected at 120 months was 92 and 38% for patients younger and older than 45 years, respectively (p=0.00561). A second neoplasia was diagnosed in 8 patients. The development of a tumor in 4 cases (breast, lung and thyroid cancer) was likely RT-related. Only 1 patient not receiving RT developed acute myeloid leukemia. The EFS and OS of the 141 early-stage patients treated with CT + RT (n=62) or with CT alone (n=79) were not statistically different.

Clinicopathologic features and therapy outcome in childhood Hodgkin’s lymphoma: a report from tertiary care center in Saudi Arabia

“…In our cohort, the percentage of cHL and NLPHL were 88.7% and 11.3%; respectively. NS subtype was more prominent than MC, 55% and 22.5% respectively, which is similar to several European and US studies [16,21]. On the other hand, some developing countries showed that MC subtype was more prominent than NS.…”

“…Other countries with low socioeconomic level showed a similar percentage [19], Sherief et al showed a higher percentage of advanced stage 56% in comparison to the early stage 44% [17]. In contrast, the European countries with higher socioeconomic level showed a lower percentage of advanced disease, may be due to early diagnosis, Aquino et al showed early and advanced stages, 70% and 30%, respectively [16].…”

“…HL is considered a highly curable disease among other malignancies; it has a worldwide clinical and epidemiological variation [16]. Our study discussed the epidemiological, clinical characteristics, and current management strategies with special attention to longterm outcome and late toxicity of pediatric HL in one of the biggest referral center in Saudi Arabia.…”

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin’s lymphoma

“…Our whole cohort revealed a male-to-female ratio of 2.2:1; this male predominance and other patients and disease characteristics at relapse were reported in many other studies (27)(28)(29). The percentage of patients with first treatment failure whether refractory or early and late relapse was also comparable to what was reported in the literature (7) (9).…”