Filomena Emanuela Laddaga1, Marco Moschetta2, Tommasina Perrone3, Sebastio Perrini4, Paolo Colonna5, Giuseppe Ingravallo6, Dario D'abbicco7, Giorgina Specchia3, Francesco Gaudio8. 1. Department of Pathology, University Hospital Policlinico, Bari, Italy. 2. Department of Emergency and Organ Transplantation (D.E.T.O.), Breast Unit, University of Bari, Bari, Italy. 3. Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy. 4. Department of Emergency and Organ Transplantation (D.E.T.O.), Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari, Bari, Italy. 5. Department of Cardiology, University Hospital Policlinico, Bari, Italy. 6. Department of Emergency and Organ Transplantation (D.E.T.O.), Pathology Section, University of Bari, Bari, Italy. 7. Department of Emergency and Organ Transplantation (D.E.T.O.), Institute of General Surgery "G Marinaccio," University of Bari, Bari, Italy. 8. Department of Emergency and Organ Transplantation (D.E.T.O.), Hematology Section, University of Bari, Bari, Italy. Electronic address: fragaudio@alice.it.
Abstract
INTRODUCTION: This retrospective study was focused on 96 patients (median age at diagnosis, 35 years) with newly diagnosed Hodgkin lymphoma (HL) treated at the University Hospital of Bari (Italy) between 2005 and 2008, to evaluate the outcome and the long-term toxicity. PATIENTS AND METHODS: First-line chemotherapy was ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in all patients; 49 (51%) patients had undergone radiotherapy. At the end of treatment, 75 (78%) patients were in complete remission (CR); 18 (24%) of 75 patients relapsed after first-line treatment; 20 (21%) underwent autologous hematopoietic stem cell transplantation, and 3 (3%) underwent allogeneic stem cell transplantation. RESULTS: After a median follow-up of 12 years, 85 (88%) patients are alive in CR, and 11 (14%) have died (2 of a second neoplasia, 1 of infection, and 8 of the disease). The 140-month Kaplan-Meier survival estimates were 86%. Three women became pregnant and each gave birth to a healthy child. The most prevalent chronic conditions at last follow-up were: a reduction in lung transfer factor for carbon monoxide (40%), fatigue (31%), hypothyroidism (30%), and infertility (16%). CONCLUSIONS: Results of this study offer indications about how long after the initial treatment excess deaths from causes other than HL begin to occur. However, challenges remain, namely establishing the optimal time to begin screening for potential late complications and developing better surveillance guidelines. Further work is needed to identify risk factors that may predict specific late effects.
INTRODUCTION: This retrospective study was focused on 96 patients (median age at diagnosis, 35 years) with newly diagnosed Hodgkin lymphoma (HL) treated at the University Hospital of Bari (Italy) between 2005 and 2008, to evaluate the outcome and the long-term toxicity. PATIENTS AND METHODS: First-line chemotherapy was ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) in all patients; 49 (51%) patients had undergone radiotherapy. At the end of treatment, 75 (78%) patients were in complete remission (CR); 18 (24%) of 75 patients relapsed after first-line treatment; 20 (21%) underwent autologous hematopoietic stem cell transplantation, and 3 (3%) underwent allogeneic stem cell transplantation. RESULTS: After a median follow-up of 12 years, 85 (88%) patients are alive in CR, and 11 (14%) have died (2 of a second neoplasia, 1 of infection, and 8 of the disease). The 140-month Kaplan-Meier survival estimates were 86%. Three women became pregnant and each gave birth to a healthy child. The most prevalent chronic conditions at last follow-up were: a reduction in lung transfer factor for carbon monoxide (40%), fatigue (31%), hypothyroidism (30%), and infertility (16%). CONCLUSIONS: Results of this study offer indications about how long after the initial treatment excess deaths from causes other than HL begin to occur. However, challenges remain, namely establishing the optimal time to begin screening for potential late complications and developing better surveillance guidelines. Further work is needed to identify risk factors that may predict specific late effects.