Early response to chemotherapy as a prognostic factor in Hodgkin's disease

Abstract We have analyzed paraffin sections from 190 patients with histologically confirmed Hodgkin’s disease (HD) for the presence of Epstein-Barr virus (EBV) using in situ hybridization to detect the EBV-encoded Epstein-Barr virus early RNAs (EBERs) and immunohistochemistry to identify latent membrane protein-1 (LMP1) expression. EBV was present in the tumor cells in 51 HD cases (27%) and was mainly confined to the mixed cellularity and nodular sclerosis subtypes. There was no difference between EBV-positive and EBV-negative HD patients with regard to age, clinical stage, presentation, and the number of alternating chemotherapy cycles of ChIVPP and PABIOE received. The complete remission rate after study chemotherapy was 80% in EBV-positive patients versus 69% in EBV-negative patients (P = .05). The 2-year failure-free survival rate was significantly better for EBV-positive patients when compared with the EBV-negative HD group (P = .02). Although 2-year and 5-year overall survival rates were better for EBV-positive HD patients, the differences were not statistically significant (P = .18 andP = .40, respectively). In conclusion, the results confirm the favorable prognostic value of EBV in the tumor cells of HD patients and suggest important differences in response to chemotherapy between EBV-positive and EBV-negative patients.

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Histology as a Prognostic Factor in 100 Cases of Hodgkin's Disease

Tumori Journal ◽

10.1177/030089166605200606 ◽

1966 ◽

Vol 52 (6) ◽

pp. 451-464 ◽

Cited By ~ 7

Author(s):

Sergio Di Pietro ◽

Federico Pizzetti

Keyword(s):

Prognostic Factor ◽

National Cancer Institute ◽

Hodgkin's Disease ◽

Hodgkin’S Disease ◽

Clinical Stage ◽

The Third ◽

Nodular Sclerosis ◽

At Iii ◽

Mediastinal Involvement

The paper deals with 100 cases of Hodgkin's disease, treated at the National Cancer Institute of Milan from 1949 to 1958, all submitted to clinical follow-up until the end of November 1966 or death. Histologically, the 100 cases were grouped as follows: 14 paragranulomas, 15 nodular scleroses, 49 polymorphous granulomas and 22 Hodgkin's sarcomas. Paragranulomas showed the best average median and 10-year survivals, nodular sclerosis the best 5-year survivals; Hodgkin's sarcomas showed the worst clinical evolution, without 10-year survivals. The behaviour of the disease was found to be more unfavourable in the third and fourth decades of life, more favourable in the fifth decade. In men the evolution was slower, after an initial unfavourable course; no 10-year survival was observed in women. Nodular sclerosis prevailed in early diagnosed patients, paragranuloma and Hodgkin's sarcoma in late diagnosed cases. Eighty-eight of the 100 patients were at III and IV clinical stage at admission, only 12 at I or II stage. Nearly all cases of nodular sclerosis concerned patients at the III stage, with mediastinal involvement; Hodgkin's sarcoma was more frequent in patients at the IV stage. Five-year survival at the IV stage was observed only in patients with paragranuloma or nodular sclerosis; these two histological types prevailed also in patients without general symptoms. Polymorphous granuloma and Hodgkin's sarcoma were more frequent in patients with general symptoms.

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Effect of Epstein-Barr Virus Infection on Response to Chemotherapy and Survival in Hodgkin’s Disease

Blood ◽

10.1182/blood.v94.2.442.414a46_442_447 ◽

1999 ◽

Vol 94 (2) ◽

pp. 442-447

Author(s):

Paul G. Murray ◽

Lucinda J. Billingham ◽

Hassan T. Hassan ◽

Joanne R. Flavell ◽

Paul N. Nelson ◽

...

Keyword(s):

Tumor Cells ◽

Hodgkin's Disease ◽

Epstein Barr Virus ◽

Remission Rate ◽

Hodgkin’S Disease ◽

Clinical Stage ◽

Epstein Barr Virus Infection ◽

Barr Virus ◽

Response To Chemotherapy ◽

Epstein Barr

We have analyzed paraffin sections from 190 patients with histologically confirmed Hodgkin’s disease (HD) for the presence of Epstein-Barr virus (EBV) using in situ hybridization to detect the EBV-encoded Epstein-Barr virus early RNAs (EBERs) and immunohistochemistry to identify latent membrane protein-1 (LMP1) expression. EBV was present in the tumor cells in 51 HD cases (27%) and was mainly confined to the mixed cellularity and nodular sclerosis subtypes. There was no difference between EBV-positive and EBV-negative HD patients with regard to age, clinical stage, presentation, and the number of alternating chemotherapy cycles of ChIVPP and PABIOE received. The complete remission rate after study chemotherapy was 80% in EBV-positive patients versus 69% in EBV-negative patients (P = .05). The 2-year failure-free survival rate was significantly better for EBV-positive patients when compared with the EBV-negative HD group (P = .02). Although 2-year and 5-year overall survival rates were better for EBV-positive HD patients, the differences were not statistically significant (P = .18 andP = .40, respectively). In conclusion, the results confirm the favorable prognostic value of EBV in the tumor cells of HD patients and suggest important differences in response to chemotherapy between EBV-positive and EBV-negative patients.

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Mediastinal tumor size and response to chemotherapy are the only prognostic factors in supradiaphragmatic Hodgkin's disease treated by ABVD plus radiotherapy: ten-year results of the Paris-Ouest-France 81/12 trial, including 262 patients.

Journal of Clinical Oncology ◽

10.1200/jco.1996.14.6.1928 ◽

1996 ◽

Vol 14 (6) ◽

pp. 1928-1935 ◽

Cited By ~ 36

Author(s):

P Colonna ◽

J P Jais ◽

B Desablens ◽

J L Harousseau ◽

J Brière ◽

...

Keyword(s):

Prognostic Factors ◽

Hodgkin's Disease ◽

Mediastinal Tumor ◽

Mediastinal Mass ◽

Hodgkin’S Disease ◽

Univariate Analysis ◽

Survival Rates ◽

Tumor Burden ◽

Medium Size ◽

Response To Chemotherapy

PURPOSE To identify prognostic factors in 262 patients with supradiaphragmatic Hodgkin's disease (HD), clinical stages (CS) I and II, prospectively treated between 1981 and 1988 according to the Paris-Ouest-France (POF) 81/12 protocol by three 1-month cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus methylprednisone (ABVD-MP) followed by subtotal nodal irradiation (RT). PATIENTS AND METHODS The size of mediastinal tumor (MT) was measured in all patients: 66 did not have MT (NoMT); 105 had a small-size MT (SSMT), ie, mediastinal mass ratio (MMR) less than 0.33; 58 had a medium-size MT (MSMT), ie, MMR > or = 0.33 and less than 0.45; and 33 had a bulky MT (BuMT), ie, MMR > or = 0.45. All patients received three cycles (CS IA, one cycle only) of ABVD-MP; patients in partial remission (PR) or complete remission (CR) after chemotherapy (CT) received supradiaphragmatic RT (involved fields, 40 Gy; adjacent fields, 30 Gy) plus lumboaortic and splenic RT (30 Gy); patients not in CR or PR after CT received salvage CT. RESULTS Two hundred seventeen patients (82.8%) entered CR after CT and 258 (98.5%) after RT. Ten-year freedom-from-progression (FFP) and survival rateswere 88.6% and 89.4%, respectively. According to univariate analysis, MT size and post-CT status were the only factors to influence both FFP and survival. For patients with NoMT or SSMT, those with MSMT, and those with BuMT, FFP rates were 94.1%, 87.0%, and 63.0% (P < .001), respectively, while corresponding survival rates were 92.6%, 87.2%, and 78.2% (P < .05). FFP rates were significantly different between the patients who achieved CR and those who did not achieve CR after CT: 94.6% versus 65.3% (P < .001); corresponding survival rates were 89.9% and 73.7% (P < .01). Multivariate analysis confirmed that MT size and post-CT status were the only two prognostic factors for FFP; for survival, the same two characteristics, as well as age (< 40 v > or = 40 years), significantly affected prognosis. We were thus able to identify three groups. The 33 patients (12.6%) with a BuMT had 10-year FFP and survival rates of 63.0% and 78.2%, respectively. Of 229 patients without BuMT, the 195 who attained CR after CT had an optimal prognosis (FFP, 96.6%; survival, 93.6%), while those who failed to achieve CR after CT had an intermediate prognosis (FFP, 68.8%; survival, 77.6%). CONCLUSION These results demonstrate the independent impact on HD prognosis of tumor burden and post-CT status.

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Coexistence of Hodgkin’s Lymphoma and Castleman’s Disease: A Case Report with Successful Response to Chemotherapy and Radiotherapy

Case Reports in Oncological Medicine ◽

10.1155/2013/487205 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Amina Mohtaram ◽

Mohammed Afif ◽

Tanae Sghiri ◽

Amal Rami ◽

Rachida Latib ◽

...

Keyword(s):

Lymph Node ◽

Hodgkin's Disease ◽

Cervical Lymph Node ◽

Hodgkin’S Lymphoma ◽

Hodgkin’S Disease ◽

Castleman’S Disease ◽

Hodgkin's Lymphoma ◽

Castleman's Disease ◽

Cervical Lymph Nodes ◽

Response To Chemotherapy

Background. Castleman’s disease is a rare clinicopathological entity of unknown origin. Coexistence of Hodgkin’s lymphoma and Castleman’s disease is rare. We report a case of Hodgkin’s disease of cervical lymph nodes in a patient previously diagnosed with Castleman’s disease.Case Presentation. A 43-year-old man admitted in July 2009 for a right cervical pain with lymph node at the physician examination. He underwent a right adenectomy and histological studies showed typical features of Castleman’s disease. Three years after, the patient consulted for increasing the volume of cervical lymph node. Clinical examination showed a right cervical lymph node of 3 cm. The computed tomography scan of chest, abdominal and pelvic was normal. Histological and immunohistochemical studies of cervical lymph node biopsy specimen were in favor of Castleman’s disease associated with Hodgkin’s disease. Reed-Sternberg cells were positive for CD15 and CD30. The patient received chemotherapy based on anthracyclines, bleomycin, vinblastine, and dacarbazine (ABVD) and radiotherapy with complete response.Conclusion. Prevalence of Hodgkin’s lymphoma in Castleman’s disease is more difficult to establish because of the low number of cases reported in the literature.

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