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Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: a population-based analysis.
Int J Radiat Oncol Biol Phys 2015; 92(1):76-83IJ

Abstract

PURPOSE

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is rare, comprising approximately 5% of all Hodgkin lymphoma (HL) cases. Patients with NLPHL tend to have better prognoses than those with classical HL (CHL). Our goal was to assess differences in survival between NLPHL and CHL patients, controlling for differences in patient and disease characteristics.

METHODS AND MATERIALS

Using data from the population-based Surveillance, Epidemiology and End Results (SEER) cancer registry program, we identified patients diagnosed with pathologically confirmed HL between 1988 and 2010.

RESULTS

We identified 1,162 patients with NLPHL and 29,083 patients with CHL. With a median follow-up of 7 years, 5- and 10-year overall survival (OS) rates were 91% and 83% for NLPHL, respectively, and 81% and 74% for CHL, respectively. After adjusting for all available characteristics, NLPHL (vs CHL) was associated with higher OS (hazard ratio [HR]: 0.62, P<.01) and disease-specific survival (DSS; HR: 0.48, P<.01). The male predominance of NLPHL, compared to CHL, as well as the more favorable prognostic features in NLPHL patients are most pronounced in NLPHL patients <20 years old. Among all NLPHL patients, younger patients were less likely to receive radiation, and radiation use has declined by 40% for all patients from 1988 to 2010. Receipt of radiation was associated with better OS (HR: 0.64, P=.03) and DSS (HR: 0.45, P=.01) in NLPHL patients after controlling for available baseline characteristics. Other factors associated with OS and DSS in NLPHL patients are younger age and early stage.

CONCLUSIONS

Our results in a large population dataset demonstrated that NLPHL patients have improved prognosis compared to CHL patients, even after accounting for stage and baseline characteristics. Use of radiation is declining among NLPHL patients despite an association in this series between radiation and better DSS and OS. Unique treatment strategies for NLPHL are warranted in both early and advanced stage disease.

Authors+Show Affiliations

Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.Department of Epidemiology and Biostatistics, Health Outcomes Research Group, New York, New York.Department of Epidemiology and Biostatistics, Health Outcomes Research Group, New York, New York.Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York. Electronic address: yahalomj@mskcc.org.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25863756

Citation

Gerber, Naamit K., et al. "Characteristics and Outcomes of Patients With Nodular Lymphocyte-predominant Hodgkin Lymphoma Versus Those With Classical Hodgkin Lymphoma: a Population-based Analysis." International Journal of Radiation Oncology, Biology, Physics, vol. 92, no. 1, 2015, pp. 76-83.
Gerber NK, Atoria CL, Elkin EB, et al. Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: a population-based analysis. Int J Radiat Oncol Biol Phys. 2015;92(1):76-83.
Gerber, N. K., Atoria, C. L., Elkin, E. B., & Yahalom, J. (2015). Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: a population-based analysis. International Journal of Radiation Oncology, Biology, Physics, 92(1), pp. 76-83. doi:10.1016/j.ijrobp.2015.02.012.
Gerber NK, et al. Characteristics and Outcomes of Patients With Nodular Lymphocyte-predominant Hodgkin Lymphoma Versus Those With Classical Hodgkin Lymphoma: a Population-based Analysis. Int J Radiat Oncol Biol Phys. 2015 May 1;92(1):76-83. PubMed PMID: 25863756.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: a population-based analysis. AU - Gerber,Naamit K, AU - Atoria,Coral L, AU - Elkin,Elena B, AU - Yahalom,Joachim, Y1 - 2015/03/14/ PY - 2014/12/15/received PY - 2015/01/27/revised PY - 2015/02/05/accepted PY - 2015/4/13/entrez PY - 2015/4/13/pubmed PY - 2015/6/17/medline SP - 76 EP - 83 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 92 IS - 1 N2 - PURPOSE: Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is rare, comprising approximately 5% of all Hodgkin lymphoma (HL) cases. Patients with NLPHL tend to have better prognoses than those with classical HL (CHL). Our goal was to assess differences in survival between NLPHL and CHL patients, controlling for differences in patient and disease characteristics. METHODS AND MATERIALS: Using data from the population-based Surveillance, Epidemiology and End Results (SEER) cancer registry program, we identified patients diagnosed with pathologically confirmed HL between 1988 and 2010. RESULTS: We identified 1,162 patients with NLPHL and 29,083 patients with CHL. With a median follow-up of 7 years, 5- and 10-year overall survival (OS) rates were 91% and 83% for NLPHL, respectively, and 81% and 74% for CHL, respectively. After adjusting for all available characteristics, NLPHL (vs CHL) was associated with higher OS (hazard ratio [HR]: 0.62, P<.01) and disease-specific survival (DSS; HR: 0.48, P<.01). The male predominance of NLPHL, compared to CHL, as well as the more favorable prognostic features in NLPHL patients are most pronounced in NLPHL patients <20 years old. Among all NLPHL patients, younger patients were less likely to receive radiation, and radiation use has declined by 40% for all patients from 1988 to 2010. Receipt of radiation was associated with better OS (HR: 0.64, P=.03) and DSS (HR: 0.45, P=.01) in NLPHL patients after controlling for available baseline characteristics. Other factors associated with OS and DSS in NLPHL patients are younger age and early stage. CONCLUSIONS: Our results in a large population dataset demonstrated that NLPHL patients have improved prognosis compared to CHL patients, even after accounting for stage and baseline characteristics. Use of radiation is declining among NLPHL patients despite an association in this series between radiation and better DSS and OS. Unique treatment strategies for NLPHL are warranted in both early and advanced stage disease. SN - 1879-355X UR - https://www.unboundmedicine.com/medline/citation/25863756/Characteristics_and_outcomes_of_patients_with_nodular_lymphocyte_predominant_Hodgkin_lymphoma_versus_those_with_classical_Hodgkin_lymphoma:_a_population_based_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(15)00179-0 DB - PRIME DP - Unbound Medicine ER -