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Lymphocyte-depleted classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin study group.

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.

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  • Authors+Show Affiliations

    ,

    University Hospital of Cologne, Cologne, Germany.

    , , , , , , ,

    Source

    MeSH

    Adolescent
    Adult
    Antineoplastic Combined Chemotherapy Protocols
    Disease-Free Survival
    Female
    Germany
    Hodgkin Disease
    Humans
    Kaplan-Meier Estimate
    Lymphocytes
    Lymphopenia
    Male
    Middle Aged
    Neoplasm Staging
    Retrospective Studies
    Risk Factors
    Treatment Outcome
    Young Adult

    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 -