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Relapse Risk and Survival With Contemporary Therapy in Young Patients With Hodgkin Lymphoma

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Key Points

  • Risk of relapse and losses in expectation of lifetime were low among all patients.
  • Outcomes were particularly good among patients achieving event-free survival for 24 months.

In a Nordic Lymphoma Epidemiology Group study reported in the Journal of Clinical Oncology, Biccler et al found that relapse risk and loss in expectation of lifetime were low in young patients receiving contemporary therapy for classical Hodgkin lymphoma. Outcomes were particularly good among patients achieving event-free survival for 24 months.

The study involved a Nordic cohort of 2,582 patients diagnosed at ages 18 to 49 years between 2000 and 2013. Five-year relapse risk and 5-year restricted losses in expectation of lifetime were estimated for all patients and for those who achieved event-free survival for 12 (EFS12), 24 (EFS24), 36 (EFS36), or 60 (EFS60) months.

Relapse Risk and Loss in Expectation of Lifetime

The median follow-up was 9 years (range = 2.9–16.8 years). Among all patients, 5-year overall survival was 95%. The 5-year risk of relapse was 13.4% among all patients, and risk decreased to 4.2% among those achieving EFS24. Risk of relapse was comparable for patients receiving 6 to 8 cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) and those receiving 6 to 8 cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), despite the fact that patients receiving BEACOPP had more adverse risk criteria. 

Both when assessed from diagnosis (45 days) and among patients who achieved EFS24 (13 days), losses in expectation of lifetime during the following 5 years were small; the loss was 8 days among patients achieving EFS60. Estimated losses in expectation of lifetime during the 5 years from diagnosis were 67 days among patients with advanced-stage disease and 14 days among those with limited-stage disease; the corresponding estimates were 23 days and 2 days among patients achieving EFS24.

The investigators concluded, “Real-world data on young patients with classical Hodgkin lymphoma from the Nordic countries show excellent outcomes. The outlook is particularly favorable for patients who reach EFS24, which supports limited relapse-oriented clinical follow-up.”

Jorne Lionel Biccler, MSc, of the Department of Hematology, Aalborg University Hospital, Denmark, is the corresponding author for the Journal of Clinical Oncology article.

Disclosure: The study authors' full disclosures can be found at jco.ascopubs.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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