hematology department sfax hospital
Contributions
Type: Publication Only
Background
Hodgkin lymphoma(HL) is a curable hemopathy. Several groups have established management protocols for this disease. The Tunisian group has adopted a third version of a national consensus: MDH2008
Aims
assessment of therapeutic response of hogkin lymphoma treated according the national protocol HL 2008.
Methods
Between Mai 2009 and decembre 2013,71 patients were enrolled in HL-2008 protocol ( a third version of prospective trial) at the haematology department of Hedi Chaker hospital (Sfax). HL-2008 defined 5groups : G1 : favorable early stage, G2 : unfavorable early stage, G3 : advanced stage and localised stage with mediastinal bulk(MTI>0.35), G4 : early stage in elderly patients, G5 : advanced stage in elderly group. We recommanded 2 cycles ABVD+radiotherapy (IFRT) for G1, 4 cycles of ABVD + IFRT for G2, 8cycles of BEACOPP (4 escalated+ 4 baseline) for G3. Elderly groups recieved 6 and 8 cycles of ABVD for G4 and G5 resectively. Early assessment of response was recommanded after 2 cycles in each group and an escalation to BEACOPP-R took place if response was less than 75%. The date of point is in january 2015. Our study determine therapeutic response, the overall survival (OS), event free survival (EFS), relapse free survival (RFS) and factors forecast which influenced these survivals.
Results
Median age was 33 years (range16-82) with sex ratio=0.87. 62% of patients were treated in G3, 21% in G2, 7% in G5, 6% in G1 and 4% in G4. 86% of patients were in complete response after the first line therapy. 7% of patients were refractory. OS, EFS, RFS were respectively 91%, 82% and 92%.
5 relapse were noted. There were grade 3-4 hematological toxicities only in patients treated with BEACOPP. 3 toxic deaths were noted 1 with escalated BEACOPP and two with ABVD treating elderly(G5). In univariante study, chemosensivity (2cure) and therapeutic response at the end of treatment were 2 predictive prognostic factors for OS (p=0.01, p<0.001), EFS (p<0.001, p<0.001). Bulky mediastinal disease was a significant adverse prognostic factor for the EFS and the RFS (p=0.03, p=0.009).
Summary
Comparatively to the second version, intensive chemotherapy for unfavorable HL( advanced stage and bulky medaistinal disease with stage II), RFS and OS are better.
Keyword(s): Hodgkin's lymphoma, Survival, Toxicity, Treatment
Session topic: Publication Only
Type: Publication Only
Background
Hodgkin lymphoma(HL) is a curable hemopathy. Several groups have established management protocols for this disease. The Tunisian group has adopted a third version of a national consensus: MDH2008
Aims
assessment of therapeutic response of hogkin lymphoma treated according the national protocol HL 2008.
Methods
Between Mai 2009 and decembre 2013,71 patients were enrolled in HL-2008 protocol ( a third version of prospective trial) at the haematology department of Hedi Chaker hospital (Sfax). HL-2008 defined 5groups : G1 : favorable early stage, G2 : unfavorable early stage, G3 : advanced stage and localised stage with mediastinal bulk(MTI>0.35), G4 : early stage in elderly patients, G5 : advanced stage in elderly group. We recommanded 2 cycles ABVD+radiotherapy (IFRT) for G1, 4 cycles of ABVD + IFRT for G2, 8cycles of BEACOPP (4 escalated+ 4 baseline) for G3. Elderly groups recieved 6 and 8 cycles of ABVD for G4 and G5 resectively. Early assessment of response was recommanded after 2 cycles in each group and an escalation to BEACOPP-R took place if response was less than 75%. The date of point is in january 2015. Our study determine therapeutic response, the overall survival (OS), event free survival (EFS), relapse free survival (RFS) and factors forecast which influenced these survivals.
Results
Median age was 33 years (range16-82) with sex ratio=0.87. 62% of patients were treated in G3, 21% in G2, 7% in G5, 6% in G1 and 4% in G4. 86% of patients were in complete response after the first line therapy. 7% of patients were refractory. OS, EFS, RFS were respectively 91%, 82% and 92%.
5 relapse were noted. There were grade 3-4 hematological toxicities only in patients treated with BEACOPP. 3 toxic deaths were noted 1 with escalated BEACOPP and two with ABVD treating elderly(G5). In univariante study, chemosensivity (2cure) and therapeutic response at the end of treatment were 2 predictive prognostic factors for OS (p=0.01, p<0.001), EFS (p<0.001, p<0.001). Bulky mediastinal disease was a significant adverse prognostic factor for the EFS and the RFS (p=0.03, p=0.009).
Summary
Comparatively to the second version, intensive chemotherapy for unfavorable HL( advanced stage and bulky medaistinal disease with stage II), RFS and OS are better.
Keyword(s): Hodgkin's lymphoma, Survival, Toxicity, Treatment
Session topic: Publication Only