Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Binkley Michael S, Rauf M Shahzad, Milgrom Sarah A, Pinnix Chelsea C, Tsang Richard, Dickinson Michael, Ng Andrea K, Roberts Kenneth B, Gao Sarah, Balogh Alex, Ricardi Umberto, Levis Mario, Casulo Carla, Stolten Michael, Specht Lena, Plastaras John P, Wright Christopher, Kelsey Christopher R, Brady Jessica L, Mikhaeel N George, Hoppe Bradford S, Terezakis Stephanie A, Picardi Marco, Della Pepa Roberta, Kirova Youlia, Akhtar Saad, Maghfoor Irfan, Koenig Julie L, Jackson Christopher, Song Erin, Sehgal Shuchi, Advani Ranjana H, Natkunam Yasodha, Constine Louis S, Eich Hans T, Wirth Andrew, Hoppe Richard T
Аннотация
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon histologic variant, and the optimal treatment of stage I-II NLPHL is undefined. We conducted a multicenter retrospective study including patients ≥16 years of age with stage I-II NLPHL diagnosed from 1995 through 2018 who underwent all forms of management, including radiotherapy (RT), combined modality therapy (CMT; RT+chemotherapy [CT]), CT, observation after excision, rituximab and RT, and single-agent rituximab. End points were progression-free survival (PFS), freedom from transformation, and overall survival (OS) without statistical comparison between management groups. We identified 559 patients with median age of 39 years: 72.3% were men, and 54.9% had stage I disease. Median follow-up was 5.5 years (interquartile range, 3.1-10.1). Five-year PFS and OS in the entire cohort were 87.1% and 98.3%, respectively. Primary management was RT alone (n = 257; 46.0%), CMT (n = 184; 32.9%), CT alone (n = 47; 8.4%), observation (n = 37; 6.6%), rituximab and RT (n = 19; 3.4%), and rituximab alone (n = 15; 2.7%). The 5-year PFS rates were 91.1% after RT, 90.5% after CMT, 77.8% after CT, 73.5% after observation, 80.8% after rituximab and RT, and 38.5% after rituximab alone. In the RT cohort, but not the CMT cohort, variant immunoarchitectural pattern and number of sites >2 were associated with worse PFS (P < .05). Overall, 21 patients (3.8%) developed large-cell transformation, with a significantly higher transformation rate in those with variant immunoarchitectural pattern (P = .049) and number of involved sites >2 (P = .0006). OS for patients with stage I-II NLPHL was excellent after all treatments.