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High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center

Authors :
C. M. Gamboa-Alonso
César Homero Gutiérrez-Aguirre
Olga G. Cantú-Rodríguez
José Ramón Padilla-Medina
José Carlos Jaime-Pérez
Raúl Alberto Jiménez-Castillo
Leticia Alejandra Olguín-Ramírez
David Gómez-Almaguer
Source :
Revista Brasileira de Hematologia e Hemoterapia, Vol 39, Iss 4, Pp 325-330, Revista Brasileira de Hematologia e Hemoterapia v.39 n.4 2017, Revista brasileira de hematologia e hemoterapia, Associação Brasileira de Hematologia e Hemoterapia e Terapia Celular (ABHHTC), instacron:ABHHTC, Revista Brasileira de Hematologia e Hemoterapia
Publisher :
Elsevier

Abstract

Background Reports dealing with clinical outcomes of classical Hodgkin's lymphoma in low- to middle-income countries are scarce and response to therapy is poorly documented. This report describes the characteristics and clinical outcomes of patients with classical Hodgkin's lymphoma from a single institution in Latin America. Method A retrospective study was conducted over ten years of patients with classical Hodgkin's lymphoma treated at a referral center. Progression-free and overall survival rates were estimated by Kaplan–Meier analysis. The univariate Cox regression model was used to estimate associations between important variables and clinical outcomes. Main results One hundred and twenty-eight patients were analyzed. The mean age was 28.5 years. The five-year progression-free and overall survival were 37.3% and 78.9%, respectively. Of the whole group, 55 (43%) were primary refractory cases. Only 39/83 (47%) patients with advanced disease vs. 34/45 (75.6%) in early stages (p-value = 0.002) achieved complete remission. Those with advanced disease had a five-year overall survival of 68.7% vs. 91.8% for early disease (p-value = 0.132). Thirty-one patients relapsed (24.2%) and 20 (64.5%) received a transplant. The hazard ratio for progression with bone marrow infiltration was 2.628 (p-value = 0.037). For death, an International Prognostic Score ≥4 had a hazard ratio of 3.355 (p-value = 0.050) in univariate analysis. Two-thirds of classical Hodgkin's lymphoma patients diagnosed at advanced stages had a low progression-free survival but an overall survival similar to high-income countries. Conclusion Patients diagnosed with classical Hodgkin's lymphoma in Northeastern Mexico had a significantly low progression-free survival rate and presented with advanced disease, underscoring the need for earlier diagnosis and improved contemporary therapeutic strategies in these mainly young productive-age Hodgkin's lymphoma patients.

Details

Language :
English
ISSN :
18060870
Volume :
39
Issue :
4
Database :
OpenAIRE
Journal :
Revista Brasileira de Hematologia e Hemoterapia
Accession number :
edsair.doi.dedup.....2e36aa0b1107ba38f595c0e7e36e18a8