C Jackson1, B Sirohi2, D Cunningham3, A Horwich4, K Thomas5, A Wotherspoon6. 1. Department of Medicine, University of Otago, Dunedin, New Zealand. 2. Department of Medical Oncology, Max Cancer Centre, New Delhi, India. 3. Lymphoma Unit, Royal Marsden NHS Foundation Trust, London and Surrey. Electronic address: David.Cunningham@rmh.nhs.uk. 4. Academic Radiotherapy Unit, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Surrey. 5. Department of Research & Development, Royal Marsden NHS Foundation Trust, Surrey. 6. Department of Pathology, Royal Marsden NHS Foundation Trust, London.
Abstract
BACKGROUND: Lymphocyte-predominant Hodgkin disease (LPHD) is a rare subtype of Hodgkin lymphoma, for which there is limited evidence regarding the presentation, natural history and treatment outcomes. PATIENTS AND METHODS: We conducted a single-institution retrospective review all of patients diagnosed with LPHD over a 30-year period. RESULTS: Eighty-eight patients were included. Median follow-up was 13 years. Local radiotherapy or chemoradiotherapy resulted in durable disease control in patients with stage I or II disease. Advanced stage at presentation, presence of B symptoms, low albumin, and either partial response or stable disease to first treatment were associated with worse treatment outcomes. Relapse rate for the entire cohort was 44%, with an 8% rate of transformation to large-cell lymphoma. Rituximab in combination with chemotherapy resulted in durable remission in a heavily pretreated subgroup. Outcomes with autologous transplant are discussed. CONCLUSION: Our series has the longest follow-up of any report, includes the only series of patients treated with autologous transplant, and has the largest group of patients treated with rituximab and chemotherapy in this indication.
BACKGROUND: Lymphocyte-predominant Hodgkin disease (LPHD) is a rare subtype of Hodgkin lymphoma, for which there is limited evidence regarding the presentation, natural history and treatment outcomes. PATIENTS AND METHODS: We conducted a single-institution retrospective review all of patients diagnosed with LPHD over a 30-year period. RESULTS: Eighty-eight patients were included. Median follow-up was 13 years. Local radiotherapy or chemoradiotherapy resulted in durable disease control in patients with stage I or II disease. Advanced stage at presentation, presence of B symptoms, low albumin, and either partial response or stable disease to first treatment were associated with worse treatment outcomes. Relapse rate for the entire cohort was 44%, with an 8% rate of transformation to large-cell lymphoma. Rituximab in combination with chemotherapy resulted in durable remission in a heavily pretreated subgroup. Outcomes with autologous transplant are discussed. CONCLUSION: Our series has the longest follow-up of any report, includes the only series of patients treated with autologous transplant, and has the largest group of patients treated with rituximab and chemotherapy in this indication.
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