Young adults diagnosed with Hodgkin lymphoma are at risk of relapsing late: a comprehensive analysis of late relapse in Hodgkin lymphoma

Pinczés, László Imre; Miltényi, Zsófia; Illés, Árpád

doi:10.1007/s00432-018-2613-9

Cited by 5 publications

(19 citation statements)

References 26 publications

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“…In accordance with a previous report, 13 we found inferior OS in cHL patients with LR compared with patients in cCR. In the present study, cHL experiencing LR had an almost threefold increased risk of death compared with patients in cCR 4,7,9–11,15 . A number of previous studies on LR in HL do not report significant differences in OS between LR and cCR patients.…”

Section: Discussioncontrasting

confidence: 52%

“…With rare exceptions, 15 most studies found increasing age to be an independent risk factor for LR 10,12,13,30 . This observation could reflect the fact that older patients receive less intensive front‐line treatment and/or have a senescent, altered host immune system including different tumour micro‐environmental features.…”

Section: Discussionmentioning

confidence: 99%

“…The cumulative incidence of LR was 4.0% at 15 years, which is comparable to values reported in earlier studies. 11,13,15 In our study we included all late recurrences of lymphoid malignancies after an initial HL diagnosis. This is in contrast to the aforementioned studies which only included relapses with a HL relapse histology.…”

Section: Discussionmentioning

confidence: 99%

“…There is no consensus definition for late relapse, either in lymphoid malignancies in general, or specifically in HL. Earlier studies have chosen a cut‐off for late relapse at two, 7 three, 6,8,9 four 10 or five 4,5,11–15 years after initial diagnosis, or after completion of first‐line treatment. In the most recent literature, the cut‐off for LR has been five years with an incidence of 3%–5.6% 13,15,16 …”

Section: Introductionmentioning

confidence: 99%

“…While the International Prognostic Score (IPS) and interim‐positron emission topography/computed topography (PET/CT)‐scan are used for risk stratification and treatment guidance, no predictive factors for late relapse have yet been identified 4,7,9,10,13,15 …”

Section: Introductionmentioning

confidence: 99%

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Late recurrence of lymphoid malignancies after initial treatment for Hodgkin lymphoma – A study from the Danish Lymphoma Registry

Andersen

Hamilton-Dutoit

Modvig³

et al. 2022

Br J Haematol

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Summary We analysed a large cohort of Hodgkin lymphoma (HL) patients in order to characterize: (1) the pattern of late recurrence of lymphoid malignancies (LR) after initial treatment for HL over a 35‐year period; (2) the clinicopathological parameters influencing the risk of LR; and (3) the outcome of patients experiencing LR. We reviewed data of 3350 HL patients diagnosed in Denmark between 1982 and 2018 and registered in the Danish National Lymphoma Registry (LYFO). LR was defined as a recurrence of lymphoid malignancy at least five years after initial diagnosis. LR occurred in 58 patients, with a cumulative incidence at 10, 15 and 20 years of 2.7%, 4.0% and 5.4% respectively. LR was more frequently observed in patients with nodular lymphocyte‐predominant HL (NLPHL) [hazard ratio (HR) 4.5; 95% confidence interval (CI): 2.4–8.4, p < 0.001]. In classical HL (cHL) patients, older age and lymphocytopenia were risk factors for LR with HRs of 1.04 per additional year (95% CI: 1.02–1.06) and 5.6 (95% CI: 2.7–11.5) respectively. Mixed cellularity histological subtype was a risk factor for LR, but only in females, with a HR of 5.4 (95% CI: 1.4–20.4, p = 0.014). In contrast to what was observed in NLPHL, LR in cHL was associated with an almost threefold increased risk of death compared with patients in continuous complete remission. Approximately one fifth (22.4%) of patients with LR experienced a second relapse.

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Section: Discussioncontrasting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Late recurrence of lymphoid malignancies after initial treatment for Hodgkin lymphoma – A study from the Danish Lymphoma Registry

Andersen

Hamilton-Dutoit

Modvig³

et al. 2022

Br J Haematol

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Stage‐adapted treatment of HIV‐associated Hodgkin lymphoma: Long‐term results of a prospective, multicenter study

Hentrich,

Müller,

Wyen

et al. 2024

HemaSphere

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Results of a prospective study of stage‐adapted treatment of human immunodeficiency virus (HIV)‐associated Hodgkin lymphoma (HIV‐HL) showed a 2‐year overall survival (OS) of 90.7% with no significant difference between early favorable (EF), early unfavorable (EU), and advanced HL. Patients with EF HIV‐HL received two to four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) + 30 Gy involved field (IF) radiation, those with EU HIV‐HL received four cycles of ABVD or BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) baseline + 30 Gy IF, and six to eight cycles of BEACOPP baseline were administered in advanced disease. The objective of the present analysis is to determine long‐term outcomes of HIV‐HL. Of 108 patients, 23 (21%) had EF HL, 14 (13%) had EU HL, and 71 (66%) had advanced‐stage HL. After a median follow‐up of 9.14 (range, 0–12.9) years, there were five primary refractory HL patients (5%) and 11 relapses (10%), of which seven were late relapses (>2 years). A second primary malignancy (SPM) occurred in 10 patients after a median of 7.3 years (range, 1.5–10.7) from HL diagnosis. The 10‐year OS for patients with EF, EU, and advanced HL was 95.7%, 84.6%, and 76.1%, respectively. By multivariate analysis, Center for Disease Control and Prevention category C (hazard ratio [HR] 3.00, 95% confidence interval [CI]: 1.16–7.74, p = 0.023) and achievement of complete remission were significant for OS (HR 0.03, 95% CI: 0.01–0.08, p = 2.45 × 10−9). In conclusion, a stage‐adapted treatment approach for HIV‐HL is highly effective with long‐term survival rates similar to those reported in HIV‐uninfected HL. However, the risk for late relapse and SPM is significant.

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Successful treatment with brentuximab vedotine for a patient with very late relapse of limited stage classic Hodgkin lymphoma

et al. 2021

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Young adults diagnosed with Hodgkin lymphoma are at risk of relapsing late: a comprehensive analysis of late relapse in Hodgkin lymphoma

Abstract: Late relapse of HL presents with clinical characteristics very similar to primary disease and appears to have a good prognosis. First diagnosis in childhood or young adulthood and first line treatment before the ABVD era increases the risk of relapsing late.

Cited by 5 publications

References 26 publications

Late recurrence of lymphoid malignancies after initial treatment for Hodgkin lymphoma – A study from the Danish Lymphoma Registry

Late recurrence of lymphoid malignancies after initial treatment for Hodgkin lymphoma – A study from the Danish Lymphoma Registry

Stage‐adapted treatment of HIV‐associated Hodgkin lymphoma: Long‐term results of a prospective, multicenter study

Successful treatment with brentuximab vedotine for a patient with very late relapse of limited stage classic Hodgkin lymphoma

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