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Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group.
- Source :
-
Blood [Blood] 2018 Oct 04; Vol. 132 (14), pp. 1519-1525. Date of Electronic Publication: 2018 Jul 31. - Publication Year :
- 2018
-
Abstract
- The optimal treatment of patients with relapsed or refractory nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is ill defined. To shed more light on treatment options and outcome, we performed an analysis using the database of the German Hodgkin Study Group (GHSG). Ninety-nine patients who had received first-line treatment within 12 prospective GHSG studies conducted between 1993 and 2009, and subsequently developed disease recurrence (n = 91) or had primary disease progression (n = 8), were included. At initial NLPHL diagnosis, the median age was 40 years and 76% of patients were male. First-line treatment consisted of radiotherapy (RT) alone (20%), chemotherapy with or without RT (74%), and the anti-CD20 antibody (Ab) rituximab (6%), respectively. The median follow-up from initial diagnosis was 11.2 years. The median time to disease recurrence was 3.7 years. The applied salvage approaches included single-agent anti-CD20 Ab treatment or RT alone (37%), conventional chemotherapy (CT) with or without anti-CD20 Ab treatment with or without RT (27%) and high-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) (31%). No salvage treatment was given in 4% of patients. The 5-year progression-free survival and overall survival estimates after NLPHL recurrence were 75.6% and 89.5% (74.1% and 97.2% after single-agent anti-CD20 Ab treatment or RT alone; 68.0% and 77.8% after CT with or without anti-CD20 Ab treatment with or without RT; 84.6% and 89.8% after HDCT and ASCT). Hence, patients with relapsed or refractory NLPHL had a good overall prognosis. Factors such as time to disease recurrence and previous treatment may guide the choice of the optimal salvage approach for the individual patient.<br /> (© 2018 by The American Society of Hematology.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Immunological therapeutic use
Combined Modality Therapy
Female
Follow-Up Studies
Germany epidemiology
Hodgkin Disease epidemiology
Hodgkin Disease pathology
Hodgkin Disease radiotherapy
Humans
Male
Middle Aged
Neoplasm Recurrence, Local epidemiology
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local radiotherapy
Rituximab therapeutic use
Salvage Therapy
Stem Cell Transplantation
Survival Analysis
Young Adult
Hodgkin Disease therapy
Lymphocytes pathology
Neoplasm Recurrence, Local therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0020
- Volume :
- 132
- Issue :
- 14
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 30064977
- Full Text :
- https://doi.org/10.1182/blood-2018-02-836437