Survivorship and Patients Perspective
Dr. Ankita Sen, Dr. T. K. Dolai, Dr. S. N. Baul, Dr. P. K. Mandal, Dr. R. De, Dr. S. Dutta, Dr. P. Chakrabarti
NRS Medical College and Hospital, Kolkata, West Bengal
Hodgkins disease is a relatively less common B cell neoplasm having a heterogenous presentation with respect to age, sex, race and geographical distribution. It is of two types: Classical Hodgkins (CHL) and Nodular Lymphocyte Predominant Hodgkins Lymphoma (NLPHL). The aim of the study is to analyse the occurrence and distribution of Hodgkins Lymphoma (HL) among patients attending a tertiary care hospital, over a span of 3 years. On analysing the presentation of HL in the eastern part of India, with respect to age, sex and histological subcategorization, there is a clear predominance of CHL (90%) over NLPHL (12 out of 121 patients), with a bimodal distribution of age and a male predominance (75.2%). The most common histological subtype is CHL-Nodular Sclerosis. Majority of HL occurred in the < 20 years age group (41.3%) and >40 years age group (29.8%). Majority of CHL were treated with ABVD and only 19 patients of childhood HL (17.4%) were treated with 1st line OEPA/OPPA-COPDAC/COPP protocol. NLPHL patients were treated with R-ABVD. Relapse rate was more among NLPHL patients, 25% (3/12) with relation to CHL i.e. 14.7% (16/109). No significant difference in relapse rates were noted between the two regimens used in CHL: relapse rates in the OEPA/OPPA-COPDAC/COPP group was 15.7% (17/90) and ABVD group was 18.9% (3/19). Overall in HL, rate of relapse was less in the </ = 20 years age group. Relapse rate is 30.9%(17/55) in the </ = 20 years age group, while among adults (>20 years), relapse rate is 38.9%(28/72). For 2nd line therapy most patients received GDP, with few patients receiving DHAP or MINI BEAM. Two children with CHL received OEPA/COPDAC post 1st relapse. There were 2 patients of CHL who had progressive disease despite 2nd line therapies. They received DHAP and MINI BEAM. Those NLPHL patients who relapsed received RCVP/RCHOP. This is an ongoing study and the patients are being continuously followed up to assess further disease outcomes.