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Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group.
J Clin Oncol 2011; 29(29):3914-20JC

Abstract

PURPOSE

To investigate the clinical characteristics and treatment outcome of patients with lymphocyte-depleted classical Hodgkin's lymphoma (LDCHL) compared with other histologic subtypes of Hodgkin's lymphoma (HL).

PATIENTS AND METHODS

From a total of 12,155 evaluable patients with biopsy-proven HL treated within the German Hodgkin Study Group trials HD4 to HD15, 10,019 patients underwent central expert pathology review. Eighty-four patients with LDCHL (< 1%) were identified and confirmed. The median follow-up time was 67 months.

RESULTS

Patients with LDCHL, compared with patients with other histologic subtypes, presented more often with advanced disease (74% v 42%, respectively; P < .001) and "B" symptoms (76% v 41%, respectively; P < .001). Other risk factors were also more frequent in patients with LDCHL. Complete remission or unconfirmed complete remission was achieved in 82% of patients with LDCHL compared with 93% of patients with other HL subtypes (P < .001), and more patients with LDCHL had progressive disease. At 5 years, progression-free survival (PFS) and overall survival (OS) were significantly lower in patients with LDCHL compared with patients with other HL subtypes (PFS, 71% v 85%, respectively; P < .001; OS, 83% v 92%, respectively; P = .0018). However, when analyzing the subgroup of patients who underwent treatment with intensified or dose-dense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, patients with LDCHL (n = 39) had similar outcomes when compared with patients with other subtypes of HL (n = 3,564; P = .61).

CONCLUSION

LDCHL has a different pattern from other HL subtypes with more clinical risk factors at initial diagnosis and significantly poorer prognosis. Patients with LDCHL should be treated with modern dose-intense treatment strategies.

Authors+Show Affiliations

University Hospital of Cologne, Cologne, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21911729

Citation

Klimm, Beate, et al. "Lymphocyte-depleted Classical Hodgkin's Lymphoma: a Comprehensive Analysis From the German Hodgkin Study Group." Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, vol. 29, no. 29, 2011, pp. 3914-20.
Klimm B, Franklin J, Stein H, et al. Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group. J Clin Oncol. 2011;29(29):3914-20.
Klimm, B., Franklin, J., Stein, H., Eichenauer, D. A., Haverkamp, H., Diehl, V., ... Engert, A. (2011). Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 29(29), pp. 3914-20. doi:10.1200/JCO.2011.36.4703.
Klimm B, et al. Lymphocyte-depleted Classical Hodgkin's Lymphoma: a Comprehensive Analysis From the German Hodgkin Study Group. J Clin Oncol. 2011 Oct 10;29(29):3914-20. PubMed PMID: 21911729.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group. AU - Klimm,Beate, AU - Franklin,Jeremy, AU - Stein,Harald, AU - Eichenauer,Dennis A, AU - Haverkamp,Heinz, AU - Diehl,Volker, AU - Fuchs,Michael, AU - Borchmann,Peter, AU - Engert,Andreas, Y1 - 2011/09/12/ PY - 2011/9/14/entrez PY - 2011/9/14/pubmed PY - 2012/2/15/medline SP - 3914 EP - 20 JF - Journal of clinical oncology : official journal of the American Society of Clinical Oncology JO - J. Clin. Oncol. VL - 29 IS - 29 N2 - PURPOSE: To investigate the clinical characteristics and treatment outcome of patients with lymphocyte-depleted classical Hodgkin's lymphoma (LDCHL) compared with other histologic subtypes of Hodgkin's lymphoma (HL). PATIENTS AND METHODS: From a total of 12,155 evaluable patients with biopsy-proven HL treated within the German Hodgkin Study Group trials HD4 to HD15, 10,019 patients underwent central expert pathology review. Eighty-four patients with LDCHL (< 1%) were identified and confirmed. The median follow-up time was 67 months. RESULTS: Patients with LDCHL, compared with patients with other histologic subtypes, presented more often with advanced disease (74% v 42%, respectively; P < .001) and "B" symptoms (76% v 41%, respectively; P < .001). Other risk factors were also more frequent in patients with LDCHL. Complete remission or unconfirmed complete remission was achieved in 82% of patients with LDCHL compared with 93% of patients with other HL subtypes (P < .001), and more patients with LDCHL had progressive disease. At 5 years, progression-free survival (PFS) and overall survival (OS) were significantly lower in patients with LDCHL compared with patients with other HL subtypes (PFS, 71% v 85%, respectively; P < .001; OS, 83% v 92%, respectively; P = .0018). However, when analyzing the subgroup of patients who underwent treatment with intensified or dose-dense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, patients with LDCHL (n = 39) had similar outcomes when compared with patients with other subtypes of HL (n = 3,564; P = .61). CONCLUSION: LDCHL has a different pattern from other HL subtypes with more clinical risk factors at initial diagnosis and significantly poorer prognosis. Patients with LDCHL should be treated with modern dose-intense treatment strategies. SN - 1527-7755 UR - https://www.unboundmedicine.com/medline/citation/21911729/Lymphocyte_depleted_classical_Hodgkin's_lymphoma:_a_comprehensive_analysis_from_the_German_Hodgkin_study_group_ L2 - http://ascopubs.org/doi/full/10.1200/JCO.2011.36.4703?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -