Serum Levels of Soluble Interleukin 10 (IL-10) in Patients with Hodgkin’s Lymphoma: Predictive Value in Advanced Stage.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4590-4590 ◽  
Author(s):  
Mayda Navarrete ◽  
Andres Palacios ◽  
Maria J. Cruz ◽  
Adoracion Blanco ◽  
Isabel Caragol ◽  
...  
Keyword(s):  
Predictive Value ◽  
Hodgkin’S Lymphoma ◽  
Serum Levels ◽  
Interleukin 10 ◽  
Hodgkin's Lymphoma ◽  
Advanced Stage ◽  
Nodal Disease ◽  
First Line ◽  
Bulky Disease ◽  
First Line Therapy

Abstract Introduction. Hodgkin’s lymphoma has a high rate of cure with current therapies; however, some patients do not respond or relapse after therapy. The aim of this study is to assess the predictive value of serum soluble Interleukin 10 (sIL-10) at diagnosis in these patients. Patients and Methods. Two cohorts of 80 consecutive patients with Hodgkin’s lymphoma (40 male and 40 female) diagnosed and treated in the same institution were evaluated. All of them were clinically staged according to Ann Arbor system. The following parameters were evaluate for prognosis: age, sex, histology, clinical symptoms, extra-nodal disease, stage, treatment, blood counts (hemoglobin, white blood cells, lymphocyte and platelets), blood chemistry (b-2-microglobulin, tymidine-kinase and LDH levels), serum soluble IL-10 and IL-6 levels by using an ELISA method. Statistics: Continuous variables were compared by using Wilcoxon signed-rank test, contingence tables were used for dichotomized variables; the optimal cut-off values were calculated by using CART method. Survival curves were estimated by Kaplan-Meier method and mantel-Cox were used to compare them. Cox multiple regression analysis was performed to determinate the independent contribution of the variables.Patients received COPP (n=16), hybrid schedule (n=21), ABVD (n=35), radiotherapy alone (n=6), surgery alone (n=1), and Stanford V (n=1) as first-line therapy. Results. Median patient age was 36 years (range: 15–85 years), predominant histology was nodular-sclerosis (70%), 27 patients (34%) presented B symptoms. Bulky disease was present in 14 (17%) and bone marrow involvement in 6%. Thirty-six patients were considered as having advanced stage (II-B or II + bulky disease. III-B or III + bulky disease, and IV). The overall response rate was 92% (85% CR/CRu, and 7% PR). Eleven out of 68 patients who achieved a CR/CRu relapsed. Serum IL-10 levels were significant higher in patients with B symptoms and extra-nodal disease and correlated with β-2-microglobulin, tymidine-kinase, and (inversely) hemoglobin levels. The optimal sIL-10 serum level cut-off was established in 13.8 pg/mL. %: 54 out of 57 patients (95%), and 14 out of 23 of patients below and above this level respectively achieved a CR/CRu (P<0.001). With a median follow-up of 86 months the OS and EFS are 77% and 69% respectively. Only sIL-10 > 13.8 pg/mL had independent predictive value for EFS in the multivariate analysis. Based on this study and combining stage a serum levels of sIL-10, three subgroups could have been identify:Patients with early disease: 85% EFS at 5 years;patients with advanced stage (according to the above mentioned definition ) and serum levels of sIL-10 less than 13.8 pg/mL: 72% EFS at 5 years.; andpatients with advanced stage and serum levels of sIL-10 superior to 13.8 pg/mL: 29% EFS at 5 years (P=0.0001). Conclusion. Serum levels of sIL-10 can help us to identify a subgroup of patients with advanced disease and poorer response and EFS who may benefit from more aggressive first-line therapy. Figure Figure

Three-Dimensional Telomere Analysis Using Teloview® Technology Predicts the Response of Classic Hodgkin's Lymphoma Patients to First Line Therapy at Point of Diagnosis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 36-37
Author(s):  
Sherif Louis ◽  
Nathalie A Johnson ◽  
Pierre Brousset ◽  
Olga Ludkovski ◽  
Yulia Shifrin ◽  
...  
Keyword(s):  
Predictive Value ◽  
Hodgkin’S Lymphoma ◽  
Predictive Power ◽  
Nuclear Volume ◽  
Hodgkin's Lymphoma ◽  
Newly Diagnosed ◽  
Publicly Traded ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Classical Hodgkin's Lymphoma (cHL) has been well studied over the past few decades. Newly diagnosed patients are treated with combinations of chemotherapeutics, the most common of which includes adriamycin, bleomycin, vinblastine, dacarbazine (ABVD). Approximately 75-85% of newly diagnosed cHL patients show favourable outcomes in response to ABVD treatment resulting in long lasting remission. The remaining 15-25% of diagnosed cHL patients will either show primary resistance to ABVD or relapse during or after the completion of therapy. Despite the fact that cHL biology has been extensively investigated, a robust biomarker to predict initial anthracycline based treatment failure remains an unresolved challenge in the management of the disease. Refractory and relapsing HL patients can be treated with several other treatment modalities including the recently developed brentuximab vedotin, and the PD-1 inhibitors nivolumab and pembrolizumab. The improvement in the outcomes of refractory and relapsed cHL patients treated with such advanced therapeutics presents a rational to advance such therapeutics to first line therapy for all newly diagnosed cHL patients. However, these therapeutics are accompanied with more adverse side effects compared to ABVD, and they present a significantly higher cost burden on the healthcare systems. In addition, clinical studies have shown that not all patients do respond favourably to these therapeutics. In spite of the development of the advanced therapies, the absence of a tool to stratify cHL patients at point of diagnosis remains to be a critical unmet clinical need. In previous reports, the 3-dimensional analysis of telomeres using TeloView® technology conducted on a proof of concept cohort of 27 HL patients revealed that TeloView® analysis, on the group patient level, showed distinct telomere profiles for HL patients who relapsed versus patients who remained stable. In this report, we conducted a retrospective clinical study including a multi-centre cohort of 156 HL patients, 125 remained stable for over 5 years, and 31 patients relapsed within 12 months. We targeted to identify, on the individual patient's level, significant telomeres parameters suitable to predict individual patient outcome at point of diagnosis. General univariate analysis including t-test and Anova identified derived telomeres parameters suitable for predictive modelling analysis including: total and average telomeres length, telomeric aggregates, nuclear volume, quartile nuclear volume and very short telomeres (t-stumps). Multivariate analysis using logistic regression procedures allowed for developing of significant predictive models using combinations of 2, 3 & 4 predictors. The highest predictive power was attained by a 4-predictors model with a predictive power of 0.76 presented as area under the curve (AUC) in receiver operating characteristic (ROC) curve illustration, achieving 75% positive predictive value, and 71% negative predictive value. The results of this study offer a long awaited path to a precision medicine approach for the treatment of cHL patients. The ready-to-use predictive model will further be validated retrospectively on an independent patient cohort, and can further be validated prospectively in longitudinal studies once the test is adopted in the clinic. Disclosures Louis: Telo Genomics Corp.: Consultancy, Current equity holder in publicly-traded company. Johnson:Roche/Genentech, Merck, Bristol-Myers Squibb, AbbVie: Consultancy; AbbVie: Research Funding; Roche/Genentech, Merck: Honoraria. Ludkovski:Telo Genomics Corp.: Current Employment. Shifrin:Telo Genomics Corp.: Current Employment. Mai:Telo Genomics Corp.: Consultancy, Current equity holder in publicly-traded company. Knecht:Telo Genomics Corp.: Consultancy, Current equity holder in publicly-traded company.

Prognostic and predictive factors in early stages of classic Hodgkin’s lymphoma

2022 ◽  
pp. 7-15
Author(s):  
T. I. Bogatyreva ◽  
A. O. Afanasov ◽  
A. Yu. Terekhova ◽  
N. A. Falaleeva
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Hodgkin’S Lymphoma ◽  
Early Stage ◽  
Hodgkin's Lymphoma ◽  
Cure Rate ◽  
First Line ◽  
Bulky Disease ◽  
Cox Regression Analysis ◽  
Early Stages

Rationale. In the early stages of classical Hodgkin’s lymphoma (cHL), the cure rate reaches 85–95 %, but the long-term effects of therapy can worsen overall survival. Current trials for early stages of Hodgkin’s lymphoma with favorable prognosis address the task of maintaining cure rates while reducing sequelae. For early unfavorable stages, the challenge is to improve cure rate without increasing toxicity.Purpose. To assess the potential significance of individual risk factors for optimal choice of the first line chemotherapy in early-stage Hodgkin lymphoma.Materials and methods. This single-center retrospective study included 290 patients with early stage cHL who had received ABVD – based (n = 249; 86 %) or BEACOPP‑21 – based (n = 41; 14 %) combined modality therapy from 2000 to 2017. Progression-free survival (PFS) and overall survival (OS) were assessed in Cox regression analysis including 12 clinical parameters.Main results. At a median follow up of 60 months for the entire group, OS was 95 % and PFS was 89 %. In a multivariate analysis PFS, at 5 years, was significantly inferior in patients with mediastinal bulk, baseline lymphocytopenia (≤ 0.6 × 109/L, р = 0.002; < 1.0 × 109/L, р = 0.000) and male gender; OS was inferior only in patients with an absolute lymphocytopenia (AL). In patients with AL, PFS after ABVD-based regimen was, respectively, 12 % in the high-risk group with mediastinal bulk and 56 % without it. PFS of patients without AL when treated with ABVD did not differ compared to BEACOPP‑21 within the same prognostic group: 95.2 % vs. 92.3 % for non-bulky and 86.4 % vs. 84.2 % for bulky disease. In the absence of AL, mediastinal bulk remained the main and only risk factor in multivariate analysis.Conclusions. The ABVD regimen is highly effective in the first line of chemotherapy for cHL, except for cases with baseline lymphocytopenia, in which the early usage of the BEACOPP regimen in the escalated or 14-day variants might be justified. In patients with mediastinal bulk, standard chemotherapy is not effective enough even in the absence of AL; therefore, if an intermediate PET/CT scan is available, it seems more appropriate to use a milder ABVD regimen on the first line and leave intensive therapy for patients with proven refractory disease. Prospects for improving the efficiency are opened with the new N-AVD and A-AVD schemes, the benefits of which should be evaluated, first of all, in patients with AL and mediastinal bulk.

scholarly journals CEPP(B): an effective and well-tolerated regimen in poor-risk, aggressive non-Hodgkin's lymphoma

Blood ◽  
1990 ◽  
Vol 76 (7) ◽  
pp. 1293-1298 ◽  
Author(s):  
NJ Chao ◽  
SA Rosenberg ◽  
SJ Horning
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Medical Center ◽  
Palliative Therapy ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Eighty-three patients with intermediate- or high-grade non-Hodgkin's lymphoma were treated with CEPP(B) (cyclophosphamide, etoposide [VP- 16], procarbazine, and prednisone with or without bleomycin) chemotherapy at Stanford University Medical Center (Stanford, CA) from January 1982 through June 1989. Sixty-nine received CEPP(B) as second- line or subsequent therapy after relapse from previous combination chemotherapy, and 14 patients received CEPP(B) as first-line therapy. Of 75 patients evaluable for response, 30 patients (40%) achieved a complete response (CR) and 24 patients (32%) achieved a partial response (PR), providing an overall response rate of 72%. Complete responses were recorded on 21 of 61 (34%) patients with recurrent disease and 9 of the 14 patients who received CEPP(B) as first line therapy (64%). Myelosuppression was the major side effect of treatment, resulting in eight neutropenic-febrile episodes from a total of 253 courses. A single fatal toxic event occurred on a patient who developed adult respiratory distress syndrome. Overall, CEPP(B) was well- tolerated and proved to be effective palliative therapy for patients with non-Hodgkin's lymphoma after relapse. As such, CEPP(B) may be considered for cytoreduction before ablative therapy and bone marrow transplantation. CEPP(B) may also be considered for initial therapy in selected patients who cannot tolerate doxorubicin-containing regimens.

TARC Is Useful as Additional Prognostic Factor for Hodgkin's Lymphoma Outcome.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1557-1557
Author(s):  
Simonetta Viviani ◽  
Arabella Mazzocchi ◽  
Valeria Bonfante ◽  
Rosalba Miceli ◽  
Davide Dalu ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Bulky Disease ◽  
T Distribution

Abstract Abstract 1557 Poster Board I-580 Introduction The CC thymus and activation related chemokine TARC, a protein highly expressed by Reed-Sternberg cells and in the microenvironment of Hodgkin's lymphoma (HL) involved lymph nodes, as well as detectable in the serum of HL patients (pts), has been reported to have prognostic value in retrospective analysis. The aim of our study was to prospectively investigate the association among PET-2 results and TARC serum levels (T) in HL and the prognostic role of T in disease relapse or progression. Patients and Methods Between November 2006 and June 2009, T was measured by ELISA in 73 pts: 50 newly diagnosed untreated pts (Group U) and 23 pts relapsing or progressing after first line CT±RT (Group S). Group U pts received stage-directed therapy consisting in 4 ABVD cycles followed by IFRT for stage I-II A, and 6-8 ABVD cycles ± RT on bulky sites of disease for stage II B, III-IV. Group S pts received cytoreductive CT with Ifosfamide-containing regimens followed by HDBEAM+ASCT. T evaluation was repeated after each CT cycle, at the end of treatment and during follow-up. Results Main pts characteristics were as follows: males/females: 32/41; age<45/≥45yrs: 59/16; Nodular Sclerosis (NS) histology/other: 54/73; stage I+II/III+IV: 46/27; B symptoms: 37; bulky disease: 35; nodal/extra±nodal involvement: 49/24; >3/≤3 involved sites: 34/39; IPS>2/≤2: 8/65. Basal T (T0) (median, IQ range) was significantly higher in Group U vs S (23540, 6528-50710 vs 1448, 735-8278; Mann-Whitney test P=0.002); T0 values >536 were observed in 43 (86%) Group U pts and 18 (78%) Group S pts (536 was the 95th centile of T distribution in a group of 40 independent healthy subjects). Pts with NS, bulky disease and extranodal involvement had significantly higher T0 levels than their counterparts. After 2 CT cycles, T (T2) was significantly lower than T0 in Group U (Wilcoxon paired sample test P<0.001), but not in Group S pts (p=0.090); T2 values >536 were observed in 18 (36%) Group U pts and 14 (61%) Group S pts. PET-2 scan was positive in 20 pts (27%) (Group U: 18%, Group S: 48%); PET- 2 was positive in 19/61 pts (31%) with T0 >536 and in 1/12 pts (8%) with T0 ≤ 536; in 17/32 (53%) pts with T2 >536 and in 2/35 (6%) pts with T2 ≤ 536. The chance of having a positive PET-2 was similar in pts with T0 >536 and T2 ≤ 536 compared with pts with T0 ≤ 536 (OR: 1.1; 95% CI: 0.9-13.5), whereas it was 13-fold greater in pts with both T0 and T2 >536 (OR: 12.6; 95% CI 1.4-110). Median follow-up was 18 months (interquartile range: 13-25 months); 13 (18%) pts had relapse or progression (7 Group U, 6 Group S), 24-months progression-free survival (PFS) was 83.4% in Group U and 60.6% in Group S. PFS was 100% vs 78.6% vs 59.4% in pts with T0 ≤ 536, T0 >536 and T2 ≤ 563, and both T0 and T2 >536, respectively. Conclusions Our study confirms that HL pts have increased serum TARC values at baseline compared with healthy subjects; moreover T0 combined with values observed after 2 cycles of CT may have a role in predicting PET-2 results and disease outcome. Disclosures No relevant conflicts of interest to declare.

Standard CHOP-21 as First Line Treatment for Elderly Patients with Hodgkin’s Lymphoma.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4675-4675
Author(s):  
Arne Kolstad ◽  
Harald Holte ◽  
Ole Nome
Keyword(s):  
Elderly Patients ◽  
Hodgkin’S Lymphoma ◽  
Stage I ◽  
Hodgkin's Lymphoma ◽  
Advanced Stage ◽  
Line Treatment ◽  
First Line ◽  
Involved Field ◽  
Involved Field Radiotherapy ◽  
First Line Treatment

Abstract Background: Outcome for elderly patients with Hodgkin’s lymphoma is not as good as for younger patients, partly due to inferior capability to tolerate appropriate chemotherapy. There is no consensus on standard treatment. In 2000 we introduced CHOP-21 as standard chemotherapy for elderly Hodgkin’s lymphoma patients at our institution with the aim to improve treatment results. CHOP-21 is known to be well tolerated in older patients with non-Hodgkin’s lymphoma and contains active drugs for Hodgkin’s disease. Patients and methods: Twenty-nine consequtive patients admitted to our institution from 2000–2004, 60 years and older with Hodgkin’s lymphoma were included in this retrospective survey. Stage I/IIA patients received 2–4 cycles of CHOP-21 followed by 30–35 Gy involved field radiotherapy. Stage IIB-IV patients were treated with 6–8 cycles of CHOP-21. Selected cases received 30–35 Gy involved field radiotherapy against residual tumors. Results: The median age was 71 years (range 60–91). Sixty-two percent presented in stage IIB-IV and 38% in stage I-IIA. Forty-five percent of the early stage patients had bulky disease and/or elevated SR. For the advanced stage patients IPS score of 2–3 was the most common category (72%). B-symptoms occurred in 52% of the total population. Nodular sclerosis was the most frequent histology subgroup (38%), followed by mixed cellularity (17%). Fifty-five percent had co-morbidity prior to treatment, cardiac conditions were most common. Two cases of treatment-related deaths were seen (7%). The most common toxicity during therapy was febrile neutropenia (31%). Treatment modifications were necessary in 38% of cases. The complete response rate after CHOP +/− radiotherapy was as high as 93%. Median follow-up for the whole population is now three years. Five patients have relapsed, and four have died from Hodgkin’s lymphoma. Total overall survival (OS) at three year was 80%, and better for the stage I-IIA subgroup (90% versus 60%). Total Hodgkin-specific survival (HSS) at three years was 73%, and 80% versus 60% for early and advanced stages, respectively. No relapses have occurred after 2 years. Outcome with CHOP +/− radiotherapy for Hodgkin’s lymphoma patients 60 years and older Response 29 pts (%) NE = not evaluable, patients died after one cycle of CHOP. CR 27 (93) PR 1 (3) ORR 28 (97) NE 1 (3) Relapsed 5 (18) Cause of death Hodgkin’s lymphoma 4 (14) Toxicity 2 (7) Other 1 (3) Conclusion: The data shows that CHOP-21 is a well tolerated and highly effective first line treatment for elderly patients with Hodgkin’s lymphoma. Of particular interest were the findings that advanced stage patients did so well and that no relapses have been seen after two years.

Salvage Treatment with Ofatumumab and ESHAP (O-ESHAP) for Patients with Relapsed or Refractory Classical Hodgkin's Lymphoma After First-Line Chemotherapy: Interim Analysis of a Phase II Trial of the Spanish Group of Lymphoma and Bone Marrow Transplantation (GELTAMO)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1630-1630
Author(s):  
Carmen Martinez ◽  
Mercedes Rodriguez-Calvillo ◽  
María José Terol ◽  
Blanca Xicoy ◽  
Ramón García-Sanz ◽  
...  
Keyword(s):  
Phase Ii ◽  
Hodgkin’S Lymphoma ◽  
Phase Ii Trial ◽  
Hodgkin's Lymphoma ◽  
Hematological Toxicity ◽  
Published Data ◽  
High Dose ◽  
First Line ◽  
Bulky Disease ◽  
Line Chemotherapy

Abstract Abstract 1630 The management of recurrent or refractory Hodgkin's lymphoma (HL) remains challenging. Previous published data have suggested that infiltrating normal B lymphocytes in classic HL lesions may contribute to the survival of Hodgkin and Reed-Sternberg cells in vivo. The objective of this prospective, multicenter, phase II trial was to investigate the activity of an anti-CD20 monoclonal antibody, ofatumumab, in combination to a standard platinum-based salvage regimen, ESHAP (O-ESHAP) followed by high-dose chemotherapy and autologous stem cell transplantation (ASCT) for patients with classical HL failing to first line chemotherapy. Forty- five patients (25 M / 21 F, median age 34 years, range 18–66) were enrolled in the study between June 2010 and June 2012. Treatment consisted on three cycles of ESHAP plus ofatumumab 1,000 mg days 1 and 8 on first cycle and day 1 on second and third cycles. At the time of study entry, 66% of patients had III-IV Ann Arbor stage, 16% bulky disease, 18% B symptoms, 40% extranodal HL and 52% ≥3 involved nodal areas. We respect to response to first-line therapy, 46% patients had achieved a completed response (CR) and then relapsed, 6% had a partial remission (PR), whereas the remaining 48% were primary refractory. Eighty-one percent patients have received 3 cycles of O-ESHAP as scheduled, three patients 2, and five 1 cycle (1 patient due to toxicity, 1 patient's decision, 2 HL progression, and 4 treatments ongoing). Grade 3–4 WHO hematological toxicity was observed in 16%, 19%, and 20% after cycles 1, 2, and 3, respectively. Non-hematological toxicity was reported in 32%, 10%, and 20%, respectively. Overall response (OR) rate was 63% (49% CR and 14% PR). Response to O-ESHAP according to prior response to first-line chemotherapy is shown in table 1. Adequate PBSCs collection was achieved in 94% mobilized patients. Twenty-six out of 33 patients have already proceeded to ASCT. Two patients died of neutropenic sepsis after ASCT and HL progression, respectively. Preliminary results of this ongoing trial suggest that addition of ofatumumab to ESHAP is safe and has a promising clinical activity in patients with relapsed/refractory HL candidates to ASCT. Table 1. Response to O-ESHAP according to previous response to first-line treatment Response to first-line chemotherapy Relapsed or partial response (n=17) Refractory (n=16) Response after O-ESHAP OR 16 (94%) 7 (44%) CR 14 (82%) 3 (22%) PR 2 (12%) 4 (22%) Refractory 1 (6%) 9 (56%) Disclosures: No relevant conflicts of interest to declare.

Correlation of PET Scan Negativity and Higher Absolute Lymphocytes: Monocytes (ALC:AMC) Ratio As Prognostic Markers in Classical Hodgkin Lymphoma Patients Treated with ABVD Chemothearapy at a Single Center in Saudi Arabia

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5004-5004
Author(s):  
Ibraheem H Motabi ◽  
Syed Ziauddin A. Zaidi ◽  
Shahid Iqbal ◽  
Atta Munawar Gill ◽  
Imran Khan Tailor ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Conflicts Of Interest ◽  
Prognostic Score ◽  
Pet Scan ◽  
Hodgkin's Lymphoma ◽  
Monocyte Count ◽  
Advanced Stage ◽  
Bulky Disease ◽  
Number Of Patients ◽  
International Prognostic Score

Abstract The International Prognostic Score (IPS) is the standard stratification system for survival in patients with classical Hodgkin's lymphoma (cHL). However, the IPS only applies to patients with advanced stage disease and it does not offer risk stratification for classical Hodgkin's lymphoma patients diagnosed with limited disease [i.e., stages I and IIA, without constitutional symptoms and no bulky disease. Furthermore, early interim positron emission tomography (PET) has been shown to have a prognostic value superior to that of the IPS in patients with advanced-stage cHL in an analysis (Gallamini et al). Lymphopenia (<600/ul), monocytosis >750 per ul (Tadmore et al) and high tumor-associated macrophages (TAM) are reported to be negative prognostic factors for survival in classical Hodgkin's lymphoma (Koh et al). More recent studies suggested a prognostic role for the peripheral blood absolute lymphocyte count/absolute monocyte count (ALC/AMC) ratio at diagnosis in cHL patients treated with multitude of chemotherapies (Porrata et al, Tadmor et al). It is intriguing to investigate the significance of the ALC/AMC ratio in relation to PET negativity after treatment. Out of 164 cases of cHL treated at our center with ABVD +/- radiation therapy, we identified 70 patients who were evaluated by PET Scan. Median age was 26 years (range 14-80), 33 (47%) were stage IV, Median IPS was 3 (range1-6). We tested correlation of a high ALC/AMC ratio (>2.1) with achievement of a negative PET scan after ABVD chemotherapy. We arbitrarily chose cut-off value of >2.1 (Tadmore et al) from the multiple values reported recently, as this multicenter study had the largest number of patients. A total of 45 patients achieved a negative PET scan. Mean ALC/AMC ratio was 2.39 (range0.19-14.6). ALC/AMC ratio of >2.1 did show a trend for better OS in addition to a negative PET scan. A Spearman correlation test of a negative PET result showed a positive correlation with ALC/AMC ratio of >2.1 though it was weak. This study suggests that the ALC/AMC ratio may be a simple, inexpensive, and independent prognostic factor in cHL outcome and may have a role in the stratification of cHL patients in addition to the International Prognostic Score, TAM content and acheivement of a negative PET scan early post chemotherapy. However we plan to define our own best cut off value for ALC/AMC ratio by ROC and AUC analysis as ALC/AMC Ratio of ≥2.1 did not discriminate survival advantage very well and it may be a reason for weaker correlation with likelihood of a negative PET. Further larger studies are needed to confirm our findings. Disclosures No relevant conflicts of interest to declare.

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