Investigating early progression of Hodgkin lymphoma in a two-center analysis

J Formos Med Assoc. 2022 Jul;121(7):1215-1222. doi: 10.1016/j.jfma.2021.12.025. Epub 2022 Jan 10.

Abstract

Background/purpose: The early progression of disease (POD) of Hodgkin lymphoma (HL) leads to a poor prognosis. To identify risk factors for early POD, this retrospective two-center cohort analysis was conducted.

Methods: Medical records of HL patients between 1998 and 2020 from two referral centers were reviewed.

Results: Two-hundred and sixty-nine patients were analyzed. The distribution of early vs. advanced stages was 51.1 vs. 48.9%, respectively. The 5-year progression free survival (PFS) was 63%, and the overall survival (OS) was 87% with a median follow-up of 52.0 months. The complete remission (CR) rate was 85.7%. Disease progression or relapsed disease occurred in 33.9% (n = 85) of patients while 17.0% of this cohort had early POD within 12 months of induction therapy. Patients with early POD had a worse median OS than those without (p < 0.001). Failure to achieve post-induction CR and high international prognostic score (IPS, 3-7) were independent risk factors for early POD. Compared with chemotherapy alone, consolidative radiotherapy after induction chemotherapy was associated with a lower risk of early POD (21.3% vs. 6.2%, p = 0.006).

Conclusion: High IPS was an independent risk factor for early POD, which was less observed in those with consolidative radiotherapy.

Keywords: Disease progression; Hematopoietic stem cell transplantation; Hodgkin disease; Induction chemotherapy; Radiotherapy.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Disease-Free Survival
  • Hematopoietic Stem Cell Transplantation*
  • Hodgkin Disease* / drug therapy
  • Humans
  • Prognosis
  • Remission Induction
  • Retrospective Studies