In an analysis reported in the Journal of Clinical Oncology, Eichenauer et al found that patients with newly diagnosed nodular lymphocyte–predominant Hodgkin lymphoma treated in German Hodgkin Study Group (GHSG) trials had good long-term outcomes overall.
"The overall outcome of patients with nodular lymphocyte–predominant Hodgkin lymphoma who had received Hodgkin lymphoma–directed first-line treatment in randomized GHSG trial protocols was good. Nonetheless, treatment optimization is still necessary to reduce toxicity in standard-risk patients and to improve the prognosis in high-risk patients.”— Eichenauer et al
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Study Details
The analysis identified the long-term course of 471 patients with nodular lymphocyte–predominant Hodgkin lymphoma who had received stage-adapted first-line treatment in the randomized GHSG HD7 to HD15 trials. Among the 471 patients, 251 had early-stage, 76 had intermediate-stage, and 144 had advanced-stage disease. Treatment consisted of radiotherapy alone, chemotherapy alone, or combined modality therapy.
The median age at diagnosis was 39 years old (range = 16–75 years), and most patients were male (75.8%).
Key Findings
The median observation time was 9.2 years.
At 10 years, progression-free survival was 75.5%, including 79.7% in patients with early-stage, 72.1% in patients with intermediate-stage, and 69.8% in patients with advanced-stage disease. There were no significant differences among the risk groups (P = .7116).
At 10 years, overall survival was 92.1%, including 93.3% in patients with early-stage, 96.2% in patients with intermediate-stage, and 87.4% in patients with advanced-stage disease. Patients with advanced disease had poorer overall survival vs those with early or intermediate stage disease (P = .0386).
A total of 48 patients (10.2%) developed a second malignancy during follow-up, including non-Hodgkin lymphoma in 13, leukemia in 6, a solid tumor in 25, and unspecified malignancy in 4.
Death occurred in 43 patients (9.1%). Among these patients, 10 died from nodular lymphocyte–predominant Hodgkin lymphoma, with second malignancies (n = 20) and nonmalignant conditions possibly related to radiotherapy or chemotherapy (n = 13) constituting the majority of deaths.
The investigators concluded, “The overall outcome of patients with nodular lymphocyte–predominant Hodgkin lymphoma who had received Hodgkin lymphoma–directed first-line treatment in randomized GHSG trial protocols was good. Nonetheless, treatment optimization is still necessary to reduce toxicity in standard-risk patients and to improve the prognosis in high-risk patients.”
Andreas Engert, MD, of the First Department of Internal Medicine, University Hospital Cologne, is the corresponding author for the Journal of Clinical Oncology article.
