Survivorship and Patients Perspective
Jun Zhu, Yan-fei Liu, Meng Wu, Mingzi Yang, Aliya, Reyizha Rnuersulitan, Yuqin Song
Peking University Cancer Hospital & Institute
Aim: To retrospectively analyze the clinical characteristics, outcomes and prognostic factors correlated to early-stage classical Hodgkin lymphoma (cHL).
Methods: 222 patients with early-stage cHL who were initially referred to Peking University Cancer Hospital from January 2008 to January 2018 were included in this study.
Results: Among the 222 patients, 101 cases were female. The median age of onset was 31 (12–77) years. Double-peak pattern was not observed in age distribution. 139 (62.6%) patients were diagnosed as nodular sclerosis subtype, 64 (28.8%) patients were mixed cellularity subtype. Only thirty-eight (17.1%) patients were in stage I, 184 (82.9%) patients were in stage II. 47 (21.2%) patients presented with B symptoms, 18 (8.1%) patients with large mass (the largest diameter ≥ 10 cm). 150 (67.6%) patients received chemotherapy alone while 72 (32.4%) cases were treated with chemoradiotherapy. The most common regimen was ABVD/AVD/AVDP and was administered in 193 (86.9%) cases. BEACOPP regimen was applied in 14 (6.3%) patients. 15 cases were treated with other regimens. The median amount of chemotherapy was 6 cycles. Complete remission (CR) was achieved in 178 (80.2%) patients and partial remission (PR) in 28 (12.6%) cases after first-line therapy. Only 16 cases did not acquire response after first-line treatment. After a median follow-up time of 39.9 (4–149) months, 10 and 8 cases recurred in CR and PR patients, respectively. 10 (4.5%) patients died. Survival analysis indicated 3-year overall survival (OS) rate of 96% and 3-year progression-free survival (PFS) rate of 87%. The 5-year OS rate and 5-year PFS rate were 93% and 79%, respectively. Univariate analysis showed that B symptoms, large mass, number of involved lymph node area, elevated LDH level and serum β 2-microglobulin were prognostic factors correlated to PFS. Multivariate analysis revealed that large mass and elevated LDH level were independent prognostic factors correlated to PFS.
Conclusions: The overall prognosis of early-stage classical Hodgkin lymphoma was generally good. Large mass and elevated LDH level were independent prognostic factors correlated to PFS in our study.