INFRADIAPHRAGMATIC HODGKIN LYMPHOMA: A LARGE SERIE OF PATIENTS AT THE ERA OF TEP-CT. A PARTICULAR SUBSET OF HL?
(Abstract release date: 05/19/16)
EHA Library. Rossi C. 06/09/16; 132692; E1143
Dr. Cédric Rossi
Contributions
Contributions
Abstract
Abstract: E1143
Type: Eposter Presentation
Background
Infradiaphragmatic Hodgkin Lymphoma (IDHL) accounts for 3-11% of adult cases of stage I-II Hodgkin Lymphoma. The strategy of treatment has been improved and standardized along the last decades in most clinical subsets of HL, while it remains heterogeneous in IDHL these patients being often excluded from clinical trial. Moreover, in previous studies focused on IDHL, the patients were not staged by PET-CT and the risk was considered localized stages as advanced.
Aims
Thus, this study aimed to include PET staged patients by comparing with PET non staged patients for demographic, clinical and biological data the outcome of these patients.
Methods
The clinical, biological data at baseline, the details of treatment and outcome of patients with a first diagnosis of stage I-II of IDHL were retrospectively collected in 8 french departments of hematology. During the same period, patients with a positive HIV serology and those treated with radiotherapy alone were excluded. Also, we reported only the patients treated with ABVD regimen of chemotherapy.
Results
From 1986 to 2014, 100 patients were included whose 65 of them staged with PET. The characteristics between patients staged with or without PET-CT were significantly different for age (higher median for PET staged, 53 years vs 47 years, p=0.041), ESR (higher median for PET non staged; 27 vs 58mm, p= 0.044), haemoglobin (lower for PET non staged, 13.6 vs 12.8g/dL, p=0.0267) and frequence of central adenopathy involvement (60% vs 80%, p=0.042). Indeed, the following analyses were made in each group separately in univariate and after adjustment with these four parameters.In the PET-staged patients group, which were considered as real pure infra-diaphragmatic, the median of follow-up was 3.8 years. At five years, the PFS was 78% (IC95% 0.64-0.87) and OS was 88% (IC95% 0.73-0.95). Thirteen relapses occurred (20%) whose eleven (16%) in the five-years after diagnosis, and five died (8%), 3 from HL progression and 2 from toxicity of chemotherapy. In univariate ananalysis, bulky mass at baseline (p=0.03) and the chemo-radiotherapy combination (p=0.024) influenced the PFS and only bulky mass and the combination of treatment remained significant (p=0.008) and at the limit of statistical significativity (p=0.069) in the modelisation analysis, respectively.
Conclusion
This multicenter retrospective study including PET-staged patients, considered as pure IDHL, shows clinical and biological specific characteristics, which confirm that PET was very useful for management of these patients. Thus, IDHL could be identify as a subset of HL, in particular of elderly HL. The chemo-radiotherapy combination seemed be related to a better PFS in these patients.
Session topic: E-poster
Keyword(s): Hematological malignancy, Hodgkin's lymphoma, Radiotherapy
Type: Eposter Presentation
Background
Infradiaphragmatic Hodgkin Lymphoma (IDHL) accounts for 3-11% of adult cases of stage I-II Hodgkin Lymphoma. The strategy of treatment has been improved and standardized along the last decades in most clinical subsets of HL, while it remains heterogeneous in IDHL these patients being often excluded from clinical trial. Moreover, in previous studies focused on IDHL, the patients were not staged by PET-CT and the risk was considered localized stages as advanced.
Aims
Thus, this study aimed to include PET staged patients by comparing with PET non staged patients for demographic, clinical and biological data the outcome of these patients.
Methods
The clinical, biological data at baseline, the details of treatment and outcome of patients with a first diagnosis of stage I-II of IDHL were retrospectively collected in 8 french departments of hematology. During the same period, patients with a positive HIV serology and those treated with radiotherapy alone were excluded. Also, we reported only the patients treated with ABVD regimen of chemotherapy.
Results
From 1986 to 2014, 100 patients were included whose 65 of them staged with PET. The characteristics between patients staged with or without PET-CT were significantly different for age (higher median for PET staged, 53 years vs 47 years, p=0.041), ESR (higher median for PET non staged; 27 vs 58mm, p= 0.044), haemoglobin (lower for PET non staged, 13.6 vs 12.8g/dL, p=0.0267) and frequence of central adenopathy involvement (60% vs 80%, p=0.042). Indeed, the following analyses were made in each group separately in univariate and after adjustment with these four parameters.In the PET-staged patients group, which were considered as real pure infra-diaphragmatic, the median of follow-up was 3.8 years. At five years, the PFS was 78% (IC95% 0.64-0.87) and OS was 88% (IC95% 0.73-0.95). Thirteen relapses occurred (20%) whose eleven (16%) in the five-years after diagnosis, and five died (8%), 3 from HL progression and 2 from toxicity of chemotherapy. In univariate ananalysis, bulky mass at baseline (p=0.03) and the chemo-radiotherapy combination (p=0.024) influenced the PFS and only bulky mass and the combination of treatment remained significant (p=0.008) and at the limit of statistical significativity (p=0.069) in the modelisation analysis, respectively.
Conclusion
This multicenter retrospective study including PET-staged patients, considered as pure IDHL, shows clinical and biological specific characteristics, which confirm that PET was very useful for management of these patients. Thus, IDHL could be identify as a subset of HL, in particular of elderly HL. The chemo-radiotherapy combination seemed be related to a better PFS in these patients.
Session topic: E-poster
Keyword(s): Hematological malignancy, Hodgkin's lymphoma, Radiotherapy
Abstract: E1143
Type: Eposter Presentation
Background
Infradiaphragmatic Hodgkin Lymphoma (IDHL) accounts for 3-11% of adult cases of stage I-II Hodgkin Lymphoma. The strategy of treatment has been improved and standardized along the last decades in most clinical subsets of HL, while it remains heterogeneous in IDHL these patients being often excluded from clinical trial. Moreover, in previous studies focused on IDHL, the patients were not staged by PET-CT and the risk was considered localized stages as advanced.
Aims
Thus, this study aimed to include PET staged patients by comparing with PET non staged patients for demographic, clinical and biological data the outcome of these patients.
Methods
The clinical, biological data at baseline, the details of treatment and outcome of patients with a first diagnosis of stage I-II of IDHL were retrospectively collected in 8 french departments of hematology. During the same period, patients with a positive HIV serology and those treated with radiotherapy alone were excluded. Also, we reported only the patients treated with ABVD regimen of chemotherapy.
Results
From 1986 to 2014, 100 patients were included whose 65 of them staged with PET. The characteristics between patients staged with or without PET-CT were significantly different for age (higher median for PET staged, 53 years vs 47 years, p=0.041), ESR (higher median for PET non staged; 27 vs 58mm, p= 0.044), haemoglobin (lower for PET non staged, 13.6 vs 12.8g/dL, p=0.0267) and frequence of central adenopathy involvement (60% vs 80%, p=0.042). Indeed, the following analyses were made in each group separately in univariate and after adjustment with these four parameters.In the PET-staged patients group, which were considered as real pure infra-diaphragmatic, the median of follow-up was 3.8 years. At five years, the PFS was 78% (IC95% 0.64-0.87) and OS was 88% (IC95% 0.73-0.95). Thirteen relapses occurred (20%) whose eleven (16%) in the five-years after diagnosis, and five died (8%), 3 from HL progression and 2 from toxicity of chemotherapy. In univariate ananalysis, bulky mass at baseline (p=0.03) and the chemo-radiotherapy combination (p=0.024) influenced the PFS and only bulky mass and the combination of treatment remained significant (p=0.008) and at the limit of statistical significativity (p=0.069) in the modelisation analysis, respectively.
Conclusion
This multicenter retrospective study including PET-staged patients, considered as pure IDHL, shows clinical and biological specific characteristics, which confirm that PET was very useful for management of these patients. Thus, IDHL could be identify as a subset of HL, in particular of elderly HL. The chemo-radiotherapy combination seemed be related to a better PFS in these patients.
Session topic: E-poster
Keyword(s): Hematological malignancy, Hodgkin's lymphoma, Radiotherapy
Type: Eposter Presentation
Background
Infradiaphragmatic Hodgkin Lymphoma (IDHL) accounts for 3-11% of adult cases of stage I-II Hodgkin Lymphoma. The strategy of treatment has been improved and standardized along the last decades in most clinical subsets of HL, while it remains heterogeneous in IDHL these patients being often excluded from clinical trial. Moreover, in previous studies focused on IDHL, the patients were not staged by PET-CT and the risk was considered localized stages as advanced.
Aims
Thus, this study aimed to include PET staged patients by comparing with PET non staged patients for demographic, clinical and biological data the outcome of these patients.
Methods
The clinical, biological data at baseline, the details of treatment and outcome of patients with a first diagnosis of stage I-II of IDHL were retrospectively collected in 8 french departments of hematology. During the same period, patients with a positive HIV serology and those treated with radiotherapy alone were excluded. Also, we reported only the patients treated with ABVD regimen of chemotherapy.
Results
From 1986 to 2014, 100 patients were included whose 65 of them staged with PET. The characteristics between patients staged with or without PET-CT were significantly different for age (higher median for PET staged, 53 years vs 47 years, p=0.041), ESR (higher median for PET non staged; 27 vs 58mm, p= 0.044), haemoglobin (lower for PET non staged, 13.6 vs 12.8g/dL, p=0.0267) and frequence of central adenopathy involvement (60% vs 80%, p=0.042). Indeed, the following analyses were made in each group separately in univariate and after adjustment with these four parameters.In the PET-staged patients group, which were considered as real pure infra-diaphragmatic, the median of follow-up was 3.8 years. At five years, the PFS was 78% (IC95% 0.64-0.87) and OS was 88% (IC95% 0.73-0.95). Thirteen relapses occurred (20%) whose eleven (16%) in the five-years after diagnosis, and five died (8%), 3 from HL progression and 2 from toxicity of chemotherapy. In univariate ananalysis, bulky mass at baseline (p=0.03) and the chemo-radiotherapy combination (p=0.024) influenced the PFS and only bulky mass and the combination of treatment remained significant (p=0.008) and at the limit of statistical significativity (p=0.069) in the modelisation analysis, respectively.
Conclusion
This multicenter retrospective study including PET-staged patients, considered as pure IDHL, shows clinical and biological specific characteristics, which confirm that PET was very useful for management of these patients. Thus, IDHL could be identify as a subset of HL, in particular of elderly HL. The chemo-radiotherapy combination seemed be related to a better PFS in these patients.
Session topic: E-poster
Keyword(s): Hematological malignancy, Hodgkin's lymphoma, Radiotherapy
{{ help_message }}
{{filter}}