Lymphocyte-Rich Classical Hodgkin's Lymphoma: Clinical Presentation and Treatment Outcome in 100 Patients Treated Within German Hodgkin's Study Group Trials

2005 ◽  
Vol 23 (24) ◽  
pp. 5739-5745 ◽  
Author(s):  
Alexander Shimabukuro-Vornhagen ◽  
Heinz Haverkamp ◽  
Andreas Engert ◽  
Leopold Balleisen ◽  
Peter Majunke ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Hodgkin’S Lymphoma ◽  
Clinical Presentation ◽  
Survival Rates ◽  
Current Treatment ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Study Group ◽  
Treatment Regimens ◽  
Histologic Subtypes

Purpose To investigate the clinical characteristics and treatment outcome of patients with lymphocyte-rich classical Hodgkin's lymphoma (LRCHL) compared with other histologic subtypes of Hodgkin's lymphoma (HL). Patients and Methods From a total of 2,715 patients with biopsy-proven HL treated within the trials HD7 to HD12 of the German Hodgkin's Study Group, 100 patients (4%) with LRCHL, 145 patients (5%) with lymphocyte-predominant HL (LPHL), 1,688 patients (62%) with nodular sclerosis, 731 patients (27%) with mixed cellularity, and 23 patients (1%) with lymphocyte depletion were identified. Patients with LRCHL had a median age of 38 years (range, 16 to 74 years). Results Compared with other histologic subtypes, patients with LRCHL are, on average, older and usually present with early stages of disease (stage I, 34%; stage II, 46%). The median time of follow-up was 32.2 months (95% CI, 28.2 to 37.0 months). Complete and partial remission was achieved in 96 patients (96%) and four patients (4%), respectively, with LRCHL. The event-free and overall survival rates were 97% (95% CI, 96.7% to 96.9%) and 97% (95% CI, 96.8% to 97.0%), respectively, at 30 months. Only three patients died; all of the deaths were caused by treatment-related toxicities. Conclusion LRCHL is a distinct subtype of CHL, with features of CHL and LPHL, and is a rare entity accounting for only 4% of HLs. LRCHL has a different pattern of clinical presentation and age and sex distribution than other CHLs. It is associated with an excellent prognosis if treated with current treatment regimens. When treating patients with LRCHL, great attention should be paid to avoid acute toxicities.

Lymphocyte-Depleted Classical Hodgkin's Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group

2011 ◽  
Vol 29 (29) ◽  
pp. 3914-3920 ◽  
Author(s):  
Beate Klimm ◽  
Jeremy Franklin ◽  
Harald Stein ◽  
Dennis A. Eichenauer ◽  
Heinz Haverkamp ◽  
...  
Keyword(s):  
Risk Factors ◽  
Complete Remission ◽  
Hodgkin’S Lymphoma ◽  
Treatment Strategies ◽  
Progression Free Survival ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
German Hodgkin Study Group ◽  
Dose Dense ◽  
Histologic Subtypes

Purpose To investigate the clinical characteristics and treatment outcome of patients with lymphocyte-depleted classical Hodgkin's lymphoma (LDCHL) compared with other histologic subtypes of Hodgkin's lymphoma (HL). Patients and Methods From a total of 12,155 evaluable patients with biopsy-proven HL treated within the German Hodgkin Study Group trials HD4 to HD15, 10,019 patients underwent central expert pathology review. Eighty-four patients with LDCHL (< 1%) were identified and confirmed. The median follow-up time was 67 months. Results Patients with LDCHL, compared with patients with other histologic subtypes, presented more often with advanced disease (74% v 42%, respectively; P < .001) and “B” symptoms (76% v 41%, respectively; P < .001). Other risk factors were also more frequent in patients with LDCHL. Complete remission or unconfirmed complete remission was achieved in 82% of patients with LDCHL compared with 93% of patients with other HL subtypes (P < .001), and more patients with LDCHL had progressive disease. At 5 years, progression-free survival (PFS) and overall survival (OS) were significantly lower in patients with LDCHL compared with patients with other HL subtypes (PFS, 71% v 85%, respectively; P < .001; OS, 83% v 92%, respectively; P = .0018). However, when analyzing the subgroup of patients who underwent treatment with intensified or dose-dense bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone, patients with LDCHL (n = 39) had similar outcomes when compared with patients with other subtypes of HL (n = 3,564; P = .61). Conclusion LDCHL has a different pattern from other HL subtypes with more clinical risk factors at initial diagnosis and significantly poorer prognosis. Patients with LDCHL should be treated with modern dose-intense treatment strategies.

Non-Hodgkin's Lymphoma in the Elderly

1996 ◽  
Vol 3 (5_suppl) ◽  
pp. 5-14 ◽  
Author(s):  
Lodovico Balducci ◽  
Oscar F. Ballester
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Clinical Presentation ◽  
Treatment Strategies ◽  
The Elderly ◽  
Hodgkin's Lymphoma ◽  
Purine Analogs ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Negative Effect ◽  
Histologic Subtypes

Background The incidence of non-Hodgkin's lymphoma in the elderly continues to increase. There has been a tendency among some treating physicians to minimize appropriate workup and treatment, which may produce a negative effect on outcomes. Methods Several characteristics of non-Hodgkin's lymphoma in the elderly are reviewed, including classification and staging, pathophysiology, clinical presentation, and treatment strategies. Results The Working Formulation remains the principal classification used. In older and younger individuals, the prevalence of histologic subtypes and the stage at presentation are similar. Regardless of the regimen chosen, doxorubicin or mitoxantrone should be included if optimal responses are to be obtained. New purine analogs extend the therapeutic armamentarium. Conclusions Advanced age and comorbidities can impair the capability for treatments to control non-Hodgkin's lymphoma. To enhance results, more studies that focus on the elderly are needed on drug combinations and the newer purine analogs.

scholarly journals Cancer Survival in Saudi Arabia 2005-2009: Analysis of the Population-based Saudi Cancer Registry

2021 ◽  
Author(s):  
Mohamed Aseafan ◽  
Edward Devol ◽  
Mahmoud AlAhwal ◽  
Riad Souissi ◽  
Reham Sindi ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Survival Data ◽  
Hodgkin’S Lymphoma ◽  
Cancer Survival ◽  
Demographic Data ◽  
Survival Rates ◽  
Population Based ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Vital Status

Abstract The Saudi Cancer Registry reported in 2007 the 5-year observed survival for the most common cancer sites for the years 1994-2004. In this report we looked at the cancer survival in the period 2005-2009 and evaluated the trend over the 15 years period from 1994-2009. Cases of the top 14 cancer sites reported by the population based Saudi Cancer Registry from 1 January 2005 to December 31, 2009 were submitted for survival analysis. The vital status of those patients was collected. Analysis of survival for the above period was compared with the prior reported 2 periods (1994-1999, 2000-2004). In addition, analysis was done according to age, sex, disease stage and the province. Data of 25,969 patients of the commonest cancer sites were submitted. Of those 14,146 (54%) had complete demographic data available and vital status was reported. The observed 5-year survival for the 14,146 patients analyzed was 66%. Thyroid cancer had the highest 5- year observed survival of 94% (standard Error (SE) 0.0062), followed by Breast (72%, SE 0.0085). In hematological malignancies, Hodgkin’s Lymphoma had the highest 5-year survival of 86% (SE 0.0116). Survival rates has improved in most of the cancers sites for the studied periods except for lung, uterine and Hodgkin’s lymphoma which plateaued. Our study confirms a steady improvement in the 5-year observed survival over time for the majority of cancers. Our survival data were comparable to western countries. This data should be used by policy makers to improve on cancer care in the kingdom.

New Prognostic Score Based on Treatment Outcome of Patients With Relapsed Hodgkin’s Lymphoma Registered in the Database of the German Hodgkin’s Lymphoma Study Group

2002 ◽  
Vol 20 (1) ◽  
pp. 221-230 ◽  
Author(s):  
Andreas Josting ◽  
Jeremy Franklin ◽  
Michael May ◽  
Peter Koch ◽  
Maria K. Beykirch ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Hodgkin’S Lymphoma ◽  
Prognostic Score ◽  
Clinical Stage ◽  
Salvage Treatment ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
Karnofsky Performance Score ◽  
Lymphoma Study Group ◽  
Time To Relapse

PURPOSE: To evaluate salvage treatment outcome of patients with relapsed Hodgkin’s disease (HD) and to distinguish different risk groups using identified prognostic factors. PATIENTS AND METHODS: From 4,754 patients registered in the German Hodgkin’s Lymphoma Study Group (GHSG) database between 1988 and 1999, 422 patients with early (n = 170) or late (n = 252) relapsed HD were identified. One hundred seven patients (25%) relapsed after radiotherapy (RT) for early stages, 133 patients (32%) after combined-modality therapy for intermediate stages, and 182 patients (43%) after chemotherapy (CT) and RT to initial bulky disease or residual lymphoma for advanced stages. At relapse, characteristics of these 422 patients (median age, 38 years; range, 17 to 77) were stage III/IV, 45%; B symptoms, 24%; elevated erythrocyte sedimentation rate, 29%; anemia, 13%; and Karnofsky performance score, less than 90 in 13%. At first relapse, salvage treatment was RT in 13%, CT in 54%, and high-dose chemotherapy (HDCT) with autologous stem-cell transplantation (ASCT) in 33%. RESULTS: Median follow-up time after relapse was 45 months. Freedom from second failure (FF2F) and overall survival (OS) were 81% and 89% for relapse after RT, 33% and 46% for early relapse after CT, and 43% and 71% for late relapse after CT, respectively. In multivariate analysis, independent risk factors were time to relapse, clinical stage at relapse, and anemia at relapse. Four subgroups with significantly different FF2F and OS were identified. The prognostic score was predictive for patients who relapsed after RT, CT with conventional CT salvage, and CT with HDCT/ASCT. CONCLUSION: In the GHSG database, time to relapse and clinical stage and anemia at relapse are relevant factors and can be used to form a prognostic score for HD patients at relapse.

scholarly journals Population-based survival for cancer patients in Saudi Arabia for the years 2005–2009

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Mohamed Aseafan ◽  
Edward Devol ◽  
Mahmoud AlAhwal ◽  
Riad Souissi ◽  
Reham Sindi ◽  
...  
Keyword(s):  
Cancer Registry ◽  
Survival Data ◽  
Hodgkin’S Lymphoma ◽  
Cancer Survival ◽  
Demographic Data ◽  
Survival Rates ◽  
Population Based ◽  
Hodgkin's Lymphoma ◽  
Disease Stage ◽  
Vital Status

AbstractThe Saudi Cancer Registry reported in 2007 the 5-year observed survival for the most common cancer sites for the years 1994–2004. In this report we looked at the cancer survival in the period 2005–2009 and evaluated the trend over the 15 years period from 1994 to 2009. Cases of the top 14 cancer sites reported by the population based Saudi Cancer Registry from 1 January 2005 to December 31, 2009, were submitted for survival analysis. The vital status of those patients was collected. Analysis of survival for the above period was compared with the prior reported 2 periods (1994–1999, 2000–2004). In addition, analysis was done according to age, sex, disease stage and the province. Data of 25,969 patients of the commonest cancer sites were submitted. Of those 14,146 patients (54%) had complete demographic data available and vital status was reported. Thyroid cancer had the highest 5- year observed survival of 94% (95% confidence interval (CI) 93–95%)), followed by Breast (72%, 95% CI 71–74%). In hematological malignancies, Hodgkin’s Lymphoma had the highest 5-year survival of 86% (95% CI 84–88%). Survival rates has improved in most of the cancers sites for the studied periods except for lung, uterine and Hodgkin’s lymphoma which plateaued. Our study confirms a steady improvement in the 5-year observed survival over time for the majority of cancers. Our survival data were comparable to western countries. This data should be used by policy makers to improve on cancer care in the kingdom.

scholarly journals Chromosomal abnormalities in untreated patients with non-Hodgkin's lymphoma: associations with histology, clinical characteristics, and treatment outcome. The Nebraska Lymphoma Study Group

Blood ◽  
1990 ◽  
Vol 75 (9) ◽  
pp. 1841-1847 ◽  
Author(s):  
HC Schouten ◽  
WG Sanger ◽  
DD Weisenburger ◽  
J Anderson ◽  
JO Armitage
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Chromosomal Abnormalities ◽  
Clinical Findings ◽  
Hodgkin's Lymphoma ◽  
Bulky Disease ◽  
Treatment Regimens ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Skin Infiltration ◽  
Lymphoma Study Group

Abstract We describe the chromosomal abnormalities found in 104 previously untreated patients with non-Hodgkin's lymphoma (NHL) and the correlations of these abnormalities with disease characteristics. The cytogenetic method used was a 24- to 48-hour culture, followed by G- banding. Several significant associations were discovered. A trisomy 3 was correlated with high-grade NHL. In the patients with an immunoblastic NHL, an abnormal chromosome no. 3 or 6 was found significantly more frequently. As previously described, a t(14;18) was significantly correlated with a follicular growth pattern. Abnormalities on chromosome no. 17 were correlated with a diffuse histology and a shorter survival. A shorter survival was also correlated with a +5, +6, +18, all abnormalities on chromosome no. 5, or involvement of breakpoint 14q11–12. In a multivariate analysis, these chromosomal abnormalities appeared to be independent prognostic factors and correlated with survival more strongly than any traditional prognostic variable. Patients with a t(11;14)(q13;q32) had an elevated lactate dehydrogenase (LDH). Skin infiltration was correlated with abnormalities on 2p. Abnormalities involving breakpoints 6q11–16 were correlated with B symptoms. Patients with abnormalities involving breakpoints 3q21–25 and 13q21–24 had more frequent bulky disease. The correlations of certain clinical findings with specific chromosomal abnormalities might help unveil the pathogenetic mechanisms of NHL and tailor treatment regimens.

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