Survivorship and Patients Perspective
Jun Zhu, Mingzi Yang, Meng Wu, Lingyan Ping, Aliya, Yanfei Liu, Reyizha Nuersulitan, Yuqin Song
Peking University Cancer Hospital & Institute
Objective: To investigate the clinicopathological characteristics and prognosis of patients with classical Hodgkin lymphoma (cHL) from China.
Methods: From January 2008 to January 2018, 387 previously untreated cHL patients with completed clinical records were admitted in Lymphoma Department of Peking University Cancer Hospital. We retrospectively reviewed the clinical data and outcomes.
Results: Among 387 patients, 215 (56%) were male. The median age was 31 years old (6–77). The median onset time to diagnosis was 93 days. The most common initial symptom was lymph node enlargement (n = 268, 71%), especially the cervical lymph node (n = 225, 58%). At the time of diagnosis, 117 (30%) patients had extranodal lymphoma involvement; 222 (57%) patients were at limited-stage (stage I and II); 131 (34%) patients had B symptoms; 68 (18%) patients had bulky lesion (diameter>10 cm). 329 (85%) patients received ABVD regimen (adriamycin, bleomycin, vinblastine, dacarbazine) as first-line chemotherapy while 57 (15%) patients received BEACOPP regimen (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone). The overall response rate (ORR) and complete remission (CR) rate were 91% and 66%, respectively. With a median follow-up time of 42 months, the 5-year overall survival (OS) rate and 5-year progression-free survival (PFS) rate were expected to be 89.8% and 77.6%. The most common histological subtype was nodular sclerosis (NS) (n = 234, 60.5%), then followed by mixed cellular (MC) (n = 117, 30.2%), lymphocyte-predominant (LP) (n = 23, 5.9%) and lymphocyte-depletion (LD) (n = 1). 12 patients could not be subtype classified. In this study, patients with LP subtype showed a higher ORR (ORR 69.6%, P = 0.05) than other histological subtypes and elder incidence age (mean age 43 years, P < 0.01) than NS or MC subtypes. Although no significant differences of OS and PFS were found among different histological subtypes, patients with LP showed a tendency of better prognosis (5-year OS 100%, 5-year PFS 80.8%).
Conclusion: Classical Hodgkin lymphoma was most frequent in young male and presented initially as lymph node enlargement. The prognosis of cHL was favorable. NS was the most common histological subtype. LP subtype had a relative better prognosis and elder incidence age.