László Pinczés1, Zsófia Miltényi2, Árpád Illés2. 1. Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. pinczes.laszlo.imre@med.unideb.hu. 2. Department of Hematology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Abstract
PURPOSE: Majority of relapses in Hodgkin lymphoma (HL) occur within 3 years after initial treatment, late relapses (LR), happening 5 or more years after first diagnosis is rare events. Neither clinical characteristics, risk factors, nor optimal treatment is well described for LR patients. Our aim was to provide a comprehensive analysis on the LR of HL to outline a patient population at risk of relapsing late. PATIENTS AND METHODS: 637 HL patients were treated at the University of Debrecen between 1981 and 2010. Patient data was evaluated retrospectively. Survival analysis was performed using the Kaplan-Meier method and odds ratios (OR) were identified by binary logistic regression models. RESULTS: With a median observational time of 9.08 years 584 (91%) HL patients achieved complete remission (CR) after first line treatment. Relapse occurred in 176 (28%) patients, 26 (4%) of them 5 or more years after first diagnosis. With multivariable analysis, initial diagnosis before the age of 24 (p < 0.001), initial presentation between 1981 and 1990 or 1991-2000 (p = 0.025 and p = 0.023, respectively) and first line treatment with radiotherapy only (p = 0.034) were identified as independent risk factors for LR. We observed a significantly impaired OS for patients with early relapse HL compared to those in long-term remission or experiencing LR (p < 0.001). CONCLUSION: Late relapse of HL presents with clinical characteristics very similar to primary disease and appears to have a good prognosis. First diagnosis in childhood or young adulthood and first line treatment before the ABVD era increases the risk of relapsing late.
PURPOSE: Majority of relapses in Hodgkin lymphoma (HL) occur within 3 years after initial treatment, late relapses (LR), happening 5 or more years after first diagnosis is rare events. Neither clinical characteristics, risk factors, nor optimal treatment is well described for LR patients. Our aim was to provide a comprehensive analysis on the LR of HL to outline a patient population at risk of relapsing late. PATIENTS AND METHODS: 637 HL patients were treated at the University of Debrecen between 1981 and 2010. Patient data was evaluated retrospectively. Survival analysis was performed using the Kaplan-Meier method and odds ratios (OR) were identified by binary logistic regression models. RESULTS: With a median observational time of 9.08 years 584 (91%) HL patients achieved complete remission (CR) after first line treatment. Relapse occurred in 176 (28%) patients, 26 (4%) of them 5 or more years after first diagnosis. With multivariable analysis, initial diagnosis before the age of 24 (p < 0.001), initial presentation between 1981 and 1990 or 1991-2000 (p = 0.025 and p = 0.023, respectively) and first line treatment with radiotherapy only (p = 0.034) were identified as independent risk factors for LR. We observed a significantly impaired OS for patients with early relapse HL compared to those in long-term remission or experiencing LR (p < 0.001). CONCLUSION: Late relapse of HL presents with clinical characteristics very similar to primary disease and appears to have a good prognosis. First diagnosis in childhood or young adulthood and first line treatment before the ABVD era increases the risk of relapsing late.
Entities:
Keywords:
ABVD; Early relapse; Hodgkin lymphoma; Late relapse; Overall survival; Risk factors
Authors: T A Lister; D Crowther; S B Sutcliffe; E Glatstein; G P Canellos; R C Young; S A Rosenberg; C A Coltman; M Tubiana Journal: J Clin Oncol Date: 1989-11 Impact factor: 44.544
Authors: Tarec Christoffer El-Galaly; Karen Juul Mylam; Peter Brown; Lena Specht; Ilse Christiansen; Lars Munksgaard; Hans Erik Johnsen; Annika Loft; Anne Bukh; Victor Iyer; Anne Lerberg Nielsen; Martin Hutchings Journal: Haematologica Date: 2011-12-29 Impact factor: 9.941
Authors: James W Vardiman; Jüergen Thiele; Daniel A Arber; Richard D Brunning; Michael J Borowitz; Anna Porwit; Nancy Lee Harris; Michelle M Le Beau; Eva Hellström-Lindberg; Ayalew Tefferi; Clara D Bloomfield Journal: Blood Date: 2009-04-08 Impact factor: 22.113
Authors: P Brousset; D Schlaifer; F Meggetto; E Bachmann; S Rothenberger; J Pris; G Delsol; H Knecht Journal: Blood Date: 1994-10-15 Impact factor: 22.113
Authors: Lasse H Jakobsen; Martin Hutchings; Peter de Nully Brown; Johan Linderoth; Karen J Mylam; Daniel Molin; Hans E Johnsen; Martin Bøgsted; Mats Jerkeman; Tarec C El-Galaly Journal: Br J Haematol Date: 2016-02-05 Impact factor: 6.998
Authors: Maja Dam Andersen; Stephen Hamilton-Dutoit; Lena Modvig; Maja Vase; Ilse Christiansen; Jacob Haaber Christensen; Rasmus Bo Dahl-Sørensen; Danny Stoltenberg; Peter Kamper; Francesco d'Amore Journal: Br J Haematol Date: 2022-04-08 Impact factor: 8.615