Ten-year retrospective review of clinical characteristics and treatment outcomes among Thai adult patients with Hodgkin lymphoma
Keywords:
Hodgkin lymphoma, clinical predictive factors, overall survivalAbstract
Introduction: Among Thai patients, clinical characteristics and treatment outcomes in Hodgkin lymphoma remain limited. This study aimed to evaluate the clinical manifestations and treatment outcomes of adult patients with Hodgkin lymphoma. Methods: A retrospective study was conducted on adult patients with Hodgkin lymphoma at Srinagarind Hospital. Clinical characteristics and potential clinical risk factors for Hodgkin lymphoma outcomes were collected. Clinical predictive factors and overall survival were demonstrated using Cox regression analysis and Kaplan-Meier curves. Results: In a total of 84 patients, the median aged was 46.2 years old. The most common subtype of classical Hodgkin lymphoma was nodular sclerosis (33, 39.2%) and mixed cellularity
(33, 39.2%). Most patients were stage II (31, 36.9%), and more than one half had constitutional symptoms (44, 52.4%). Complete remission was significantly associated with improved overall survival according to hazard ratio (HR) analysis (HR 0.4, p-value < 0.001). A significant association between poor overall survival and the existence of disease involvement in at least 3 sites was found (HR 1.8, p-value < 0.014). Those with early stage cancer had a greater overall survival rate than patients with advanced stage, according to Kaplan-Meier curves. Conclusion: In this study, mixed cellularity and nodular sclerosis were the two most common subtypes of Hodgkin lymphoma. The most common first line therapy was ABVD. Achieved complete remission was a protective factor associated with better survival. The presence of disease involvement in at least 3 sites was a substantial risk factor for poor outcomes.
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Stein H, Pileri SA, Weiss LM, Poppema S, Gascoyne RD, Jaffe ES. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 2017. p. 424-42
Connors JM. Clinical Manifestations and Natural History of Hodgkin’s Lymphoma. The Cancer Journal. 2009;15:124-8.
Peters MV, Alison RE, Bush RS. Natural history of Hodgkin’s disease as related to staging. Cancer. 1966;19:308-16.
Cervantes F, Briones J, Bruguera M, Font C, Grau J-M, Rozman C, et al. Hodgkin’s disease presenting as a cholestatic febrile illness: incidence and main characteristics in a series of 421patients. Annals of Hematology. 1996;72:357-60.
Howell SJ, Grey M, Chang J, Morgenstern GR, Cowan RA, Deakin DP, et al. The value of bone marrow examination in the staging of Hodgkin’s lymphoma: a review of 955 cases seen in a regional cancer centre. Br J Haematol. 2002;119:408-11.
Hummel M, Anagnostopoulos I, Dallenbach F, Korbjuhn P, Dimmler C, Stein H. EBV infection patterns in Hodgkin’s disease and normal lymphoid tissue: expression and cellular localization of EBV gene products. British Journal of Haematology. 1992;82:689-94.
Ferreira JM de O, Klumb CE, Reis R de S, Santos M de O, Oliveira JFP, de Camargo B, et al. Lymphoma subtype incidence rates in children and adolescents: First report from Brazil. Cancer Epidemiology. 2012;36:e221-6.
Barros MHM, Hassan R, Niedobitek G. Disease patterns in pediatric classical Hodgkin lymphoma: a report from a developing area in Brazil. Hematol Oncol. 2011;29:190-5.
Correa P, O’Conor GT. Epidemiologic patterns of Hodgkin’s Disease. Int J Cancer. 1971;8:192-201.
Epstein MM, Chang ET, Zhang Y, Fung TT, Batista JL, Ambinder RF, et al. Dietary Pattern and Risk of Hodgkin Lymphoma in a Population-Based Case-Control Study. Am J Epidemiol. 2015;182:405-16.
Castillo JJ, Dalia S, Shum H. Meta-Analysis of the Association Between Cigarette Smoking and Incidence of Hodgkin’s Lymphoma. JCO. 2011;29:3900-6.
Garnier JL, Lebranchu Y, Dantal J, Bedrossian J, Cahen R, Assouline D, Jaccard A, Fetissoff F, Moreau A, Martin X, Delsol G, Berger F, Touraine JL. Hodgkin’s disease after transplantation. Transplantation. 1996;61:71-6.
Dal Maso L, Franceschi S, Polesel J, Braga C, Piselli P, Crocetti E, et al. Risk of cancer in persons with AIDS in Italy, 1985-1998. Br J Cancer. 2003;89:94-100.
Fallah M, Liu X, Ji J, Försti A, Sundquist K, Hemminki K. Hodgkin lymphoma after autoimmune diseases by age at diagnosis and histological subtype. Annals of Oncology. 2014;25:1397-404.
Landgren O, Engels EA, Pfeiffer RM, Gridley G, Mellemkjaer L, Olsen JH, et al. Autoimmunity and Susceptibility to Hodgkin Lymphoma: A Population-Based Case-Control Study in Scandinavia. JNCI: Journal of the National Cancer Institute. 2006;98:1321-30.
Goldin LR, Pfeiffer RM, Gridley G, Gail MH, Li X, Mellemkjaer L, et al. Familial aggregation of Hodgkin lymphoma and related tumors. Cancer. 2004;100:1902-8.
Eichenauer DA, Aleman BMP, André M, Federico M, Hutchings M, Illidge T, et al. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018;29:iv19-29.
Fermé C, Eghbali H, Meerwaldt JH, Rieux C, Bosq J, Berger F, et al. Chemotherapy plus Involved-Field Radiation in Early-Stage Hodgkin’s Disease. N Engl J Med. 2007;357:1916-27.
Sjoberg J, Halthur C, Kristinsson SY, Landgren O, Axdorph Nygell U, Dickman PW, et al. Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009. Blood. 2012;119:990-6.
Fermé C, Thomas J, Brice P, Casasnovas O, Vranovsky A, Bologna S, et al. ABVD or BEACOP baseline along with involved-field radiotherapy in early-stage Hodgkin Lymphoma with risk factors: Results of the European Organisation for Research and Treatment of Cancer (EORTC-Groupe d’Étude des Lymphomes de l’Adulte (GELA) H9-U intergroup randomised trial. European Journal of Cancer. 2017;81:45-55.
Connors JM, Jurczak W, Straus DJ, Ansell SM, Kim WS, Gallamini A, et al. Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin’s Lymphoma. N Engl J Med. 2018;378:331-44.
Chisesi T, Bellei M, Luminari S, Montanini A, Marcheselli L, Levis A, et al. Long-Term Follow-Up Analysis of HD9601 Trial Comparing ABVD Versus Stanford V Versus MOPP/EBV/CAD in Patients With Newly Diagnosed Advanced-Stage Hodgkin’s Lymphoma: A Study From the Intergruppo Italiano Linfomi. JCO. 2011;29:4227-33.
Hadley TJ. A prognostic score for advanced Hodgkin’s disease. Evidence-based Oncology. 2000;1:12-3.
Aleman BMP, Raemaekers JMM, Tirelli U, Bortolus R, van ’t Veer MB, Lybeert MLM, et al. Involved-Field Radiotherapy for Advanced Hodgkin’s Lymphoma. N Engl J Med. 2003;348:2396-406.
Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med. 2003;348:2386-95. Erratum in: N Engl J Med. 2005;353:744.
Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised Response Criteria for Malignant Lymphoma. JCO. 2007;25:579-86.
André MPE, Girinsky T, Federico M, Reman O, Fortpied C, Gotti M, et al. Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. JCO. 2017;35:1786-94.
Vakkalanka B, Link BK. Neutropenia and Neutropenic Complications in ABVD Chemotherapy for Hodgkin Lymphoma. Advances in Hematology. 2011;2011:1-7.
Klimm B, Goergen H, Fuchs M, von Tresckow B, Böll B, Meissner J, et al. Impact of risk factors on outcomes in early-stage Hodgkin’s lymphoma: an analysis of international staging definitions. Annals of Oncology. 2013;24:3070-6.
Qi S, Milgrom S, Dabaja B, Tsang R, Levis M, Ricardi U, et al. Two distinct prognostic groups in advanced-stage Hodgkin lymphoma revealed by the presence and site of bulky disease. Blood Advances. 2020;4:2064-72.
Suwanban T, Nakhakes C, Lekhakula A, Julamanee J, Norasetthada L, Nawarawong W, et al. Treating Hodgkin Lymphoma without Dacarbazine: a Lesson Learned from Thailand. Blood. 2015 Dec 3;126(23):5002-5002.
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