Hodgkin's Lymphoma in Adolescents Treated With Adult Protocols: A Report From the German Hodgkin Study Group

2009 ◽  
Vol 27 (36) ◽  
pp. 6079-6085 ◽  
Author(s):  
Dennis A. Eichenauer ◽  
Henning Bredenfeld ◽  
Heinz Haverkamp ◽  
Horst Müller ◽  
Jeremy Franklin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Hodgkin’S Lymphoma ◽  
Age Groups ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
Cox Regression Analysis ◽  
German Hodgkin Study Group ◽  
Study Protocols ◽  
Adolescent Patients

PurposeThe standard of care for adolescent patients with Hodgkin's lymphoma (HL) is undefined, particularly the choice between pediatric and adult protocols. Thus, we compared risk factors and outcome of adolescents and young adults treated within study protocols of the German Hodgkin Study Group (GHSG).Patients and MethodsThree thousand seven hundred eighty-five patients treated within the GHSG studies HD4 to HD9 were analyzed; 557 patients were adolescents age 15 to 20 years, and 3,228 patients were young adults age 21 to 45 years.ResultsLarge mediastinal mass and involvement of three or more lymph node areas were more frequent in adolescents (P < .001). The incidence of other risk factors did not differ significantly between age groups. With a median observation time of 81 months for freedom from treatment failure (FFTF) and 85 months for overall survival (OS), log-rank test showed no significant differences between age groups regarding FFTF (P = .305) and a superior OS (P = .008) for adolescents. Six-year estimates for FFTF and OS were 80% and 94%, respectively, for adolescents and 80% and 91%, respectively, for young adults. After adjustment for other predictive factors, Cox regression analysis revealed age as a significant predictor for OS (P = .004), with a higher mortality risk for young adults. Secondary malignancies were more common in young adults (P = .037).ConclusionOutcome of adolescent and young adult patients treated within GHSG study protocols is comparable. These data suggest that adult treatment protocols exhibit a safe and effective treatment option for adolescent patients with HL. However, longer follow-up, including assessment of late toxicity, is necessary for final conclusions.

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.

Hodgkin Lymphoma in Adolescents Treated with Adult Protocols: An Analysis From the German Hodgkin Study Group (GHSG).

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 719-719
Author(s):  
Dennis A. Eichenauer ◽  
Henning Bredenfeld ◽  
Jeremy Franklin ◽  
Heinz Haverkamp ◽  
Horst Mueller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Hodgkin Lymphoma ◽  
Conflicts Of Interest ◽  
Age Groups ◽  
Adolescents And Young Adults ◽  
Secondary Malignancy ◽  
Study Group ◽  
Secondary Malignancies ◽  
German Hodgkin Study Group

Abstract Abstract 719 Introduction: The standard of care for adolescent Hodgkin lymphoma (HL) patients is undefined, particularly the choice between adult and pediatric protocols. We thus analyzed and compared risk factors, outcome and incidence of secondary malignancies in adolescents and young adults treated within study protocols of the German Hodgkin Study Group (GHSG) to evaluate whether adolescents represent a distinct patient group. Patients and Methods: 3785 patients of all stages treated within the second (HD4-HD6, 1988-1993) and third (HD7-HD9, 1993-1998) trial generation of the GHSG were retrospectively analyzed. 557 patients were adolescents aged 15 to 20 and 3228 patients were young adults aged 21 to 45. Treatment consisted of chemo- and/or radiotherapy. Results: The risk factors large mediastinal mass (more than 1/3 of the maximum intrathoracic diameter) and involvement of three or more lymph node areas were more common in adolescents (30.2% vs. 20.9% and 67.7% vs. 58.7%, respectively, p<.001). The incidence of other risk factors did not differ significantly between age groups. With a median follow-up of 81 months for freedom from treatment failure (FFTF) and 85 months for overall survival (OS), FFTF rates in both groups were comparable (p=.305) while adolescents had a superior OS (p=.008). 6-year FFTF estimates were 80.2% and 79.7%, 6-year OS estimates were 93.6% and 90.9% in adolescents and young adults, respectively. Young adults had a higher risk to develop secondary malignancies. Secondary malignancy rates were 1.6% (9 of 557) in adolescents and 3.1% (101 of 3228) in young adults with secondary hematological malignancies (AML/MDS, NHL) representing the majority of cases in both groups (6/9 in adolescents and 55/101 in young adults). Since adolescents differ from young adults in terms of cancer risk in the general population, standardized incidence ratio (SIR) and absolute excess risk (AER) per 100.000 person-years were calculated. The SIR was higher in adolescents (5.56 vs. 4.58) while the AER was higher in young adults (394 vs. 194). However, differences between age groups were not significant for both. Conclusions: There are only slight differences between adolescents and young adults regarding risk factors, outcome and incidence of secondary malignancies. Therefore, treatment with adult protocols can be considered effective and safe in adolescent HL patients. Disclosures: No relevant conflicts of interest to declare.

Role of Hematotoxicity and Sex in Patients With Hodgkin's Lymphoma: An Analysis From the German Hodgkin Study Group

2005 ◽  
Vol 23 (31) ◽  
pp. 8003-8011 ◽  
Author(s):  
Beate Klimm ◽  
Thorsten Reineke ◽  
Heinz Haverkamp ◽  
Karolin Behringer ◽  
Hans T. Eich ◽  
...  
Keyword(s):  
Hodgkin’S Lymphoma ◽  
Protective Role ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
Similar Response ◽  
Who Grade ◽  
Female Patients ◽  
German Hodgkin Study Group ◽  
Severe Leucopenia

Purpose Several scores have described sex as a prognostic factor in patients with Hodgkin's lymphoma (HL). However, little is known how sex-specific factors influence treatment outcome. We systematically investigated sex differences with regard to pretreatment characteristics and therapy-related variables, and examined their influence on the outcome of HL patients. Patients and Methods This analysis comprises 4,626 HL patients of all prognostic risk groups who were enrolled onto the multicenter studies HD4 to HD9 of the German Hodgkin Study Group. At 5.5 years, 2,050 female and 2,576 male patients were analyzed. Results Male and female patients had similar prognostic factors. There was more acute chemotherapy-related hematotoxicity in women, especially more severe leucopenia (WHO grade 3/4, 69.9% female and 55.2% male; P < .0001). Importantly, this did not translate into more infections. Female patients had similar response rates but fewer relapses and deaths, leading to a significantly better freedom from treatment failure (FFTF; at 66 months, 81% female [95% CI, 79% to 82%] and 74% male [95% CI, 72% to 76%]). Severe leucopenia during chemotherapy was strongly associated with better FFTF, both for males and females. In addition, when only those patients who developed severe leucopenia within the first two cycles of chemotherapy were included, the factor maintained its protective role. Conclusion The protective role of severe leucopenia suggests the testing of a more individualized therapy. In future trials, this therapy may be tailored in a response-adapted manner depending on the individual toxicity profile within the first cycles.

scholarly journals Assessment of male fertility in patients with Hodgkin's lymphoma treated in the German Hodgkin Study Group (GHSG) clinical trials

2008 ◽  
Vol 19 (10) ◽  
pp. 1795-1801 ◽  
Author(s):  
M. Sieniawski ◽  
T. Reineke ◽  
A. Josting ◽  
L. Nogova ◽  
K. Behringer ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Male Fertility ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
German Hodgkin Study Group
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