Jun Zhu, Aliya, MengWu, Mingzi Yang, Yanfei Liu, Reyizha Nuersulitan, Yuqin Song
Peking University Cancer Hospital & Institute
Objective: To analyze the clinical characteristics, outcomes and prognostic factors of 165 patients with advanced classical Hodgkin lymphoma (cHL) from Peking University Cancer Hospital (PUCH).
Methods: From January 2008 to January 2018, 165 patients were newly diagnosed as advance-staged cHL and underwent treatment in PUCH. The clinical data of all cases were collected and analyzed.
Results: Among 165 cases, 92 (56%) were male patients. The median age was 31 years (6 to 75 years old). 45 cases were at stage IIIA, 29 cases at IIIB, 36 at IVA, and 55 at IVB. Thirty-two patients were with bulky mass (the largest diameter ≥ 7.5 cm). The median follow-up time was 43.4 months. In the whole group, the overall response rate (ORR) and complete remission (CR) rate were 88.5% and 62.4%, respectively; 5-year PFS rate and OS rate were 67.0% and 86.5%.
133 cases received ABVD regimen while 32 cases were with escalated BEACOPP regimen. The 5-year PFS of these two regimens were 65.4% vs. 67.3% (P = 0.906), 5-year OS were 88.7% vs. 86.4% (P = 0.892). 146 cases were treated with chemotherapy while 19 received chemoradiotherapy. The 5-year PFS were 64.9% vs. 82.8% (P = 0.147), 5-year OS were 86.2% vs. 87.5% (P = 0.326).
According to international prognostic scores (IPS), 163 evaluable patients were divided into low risk (IPS 1–2; n = 86) and high risk (IPS>2; n = 77) groups, the 5-year PFS were 82.2% vs. 48.0% (P < 0.01), 5-year OS were 98.7% vs. 72.5% (P < 0.01). Univariate analysis showed that stage IV, WBC>15 × 109/L, Hb < 105 g/L, PLT>350 × 109/L, albumin < 40 U/L, ALP>160 U/L, IPS>2 and not achieving CR after chemotherapy were with poor PFS (P < 0.05); age≥45, stage IV, β2-microglobubin>3 mg/L, Hb<105 g/L, albumin<40 U/L, ALP>160 U/L, IPS>2 and not achieving CR after chemotherapy were with poor OS (P < 0.05). Multivariate analysis showed that stage IV, Hb < 105 g/L and not achieving CR after chemotherapy were independent prognostic factors of PFS (P < 0.01), and age≥45, stage IV, Hb < 105 g/L and not achieving CR after chemotherapy were independent prognostic factors of OS (P < 0.05).
Conclusion: In our study, the outcomes of ABVD and escalated BEACOPP regimens showed no significant differences. Patients with high IPS had poor prognosis.