Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study.
Fiche publication
Date publication
octobre 2015
Auteurs
Membres identifiés du Cancéropôle Est :
Dr BOLOGNA Serge
Tous les auteurs :
Lazarovici J, Dartigues P, Brice P, Oberic L, Gaillard I, Hunault-Berger M, Broussais-Guillaumot F, Gyan E, Bologna S, Nicolas-Virelizier E, Touati M, Casasnovas O, Delarue R, Orsini-Piocelle F, Stamatoullas A, Gabarre J, Fornecker LM, Gastinne T, Peyrade F, Roland V, Bachy E, Andre M, Mounier N, Ferme C
Lien Pubmed
Résumé
Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in the Lymphoma Study Association centers. Progression-free survival and overall survival were analyzed, and the competing risks formulation of Cox model regression was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early-stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy and rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320-1.512], p=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234-0.643], p=0.0002). Early treatment appears beneficial over watchful waiting in terms of progression-free survival but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients are the main options to treat adult patients with a curative intent.
Référence
Haematologica. 2015 Oct 1. pii: haematol.2015.133025.