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Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG.

Publication ,  Journal Article
Binkley, MS; Rauf, MS; Milgrom, SA; Pinnix, CC; Tsang, R; Dickinson, M; Ng, AK; Roberts, KB; Gao, S; Balogh, A; Ricardi, U; Levis, M; Song, E ...
Published in: Blood
June 25, 2020

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.

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Published In

Blood

DOI

EISSN

1528-0020

Publication Date

June 25, 2020

Volume

135

Issue

26

Start / End Page

2365 / 2374

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Survival Analysis
  • Salvage Therapy
  • Retrospective Studies
  • Recurrence
  • Proportional Hazards Models
  • Progression-Free Survival
  • Positron Emission Tomography Computed Tomography
  • Neoplasms, Second Primary
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Binkley, M. S., Rauf, M. S., Milgrom, S. A., Pinnix, C. C., Tsang, R., Dickinson, M., … Hoppe, R. T. (2020). Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG. Blood, 135(26), 2365–2374. https://doi.org/10.1182/blood.2019003877

Published In

Blood

DOI

EISSN

1528-0020

Publication Date

June 25, 2020

Volume

135

Issue

26

Start / End Page

2365 / 2374

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Survival Analysis
  • Salvage Therapy
  • Retrospective Studies
  • Recurrence
  • Proportional Hazards Models
  • Progression-Free Survival
  • Positron Emission Tomography Computed Tomography
  • Neoplasms, Second Primary