HODGKIN LYMPHOMA: A RETROSPECTIVE ANALYSIS OF SURVIVAL AND TREATMENT RELATED TOXICITIES OF A COHORT OF PATIENTS DIAGNOSED BETWEEN 2005-2015
(Abstract release date: 05/19/16)
EHA Library. Brás G. 06/09/16; 132696; E1147
Dr. Gil Brás
Contributions
Contributions
Abstract
Abstract: E1147
Type: Eposter Presentation
Background
Hodgkin Lymphoma is highly sensitive to chemotherapy and radiotherapy. Treatment related toxicity is a major concern and have a negative impact on quality of life and overall survival of these patients.
Aims
To evaluate chemotherapy and radiotherapy attributable toxicity in a cohort of Hodgkin Lymphoma survivors.
Methods
We performed a retrospective analysis of a Hodgkin Lymphoma cohort diagnosed and treated in a Portuguese tertiary hospital centre, from 2005 to 2015. The toxicities assessed were: secondary neoplasia, infertility, thyroid, cardiac, pulmonary, cerebrovascular and neuropsychiatric disorders.
Results
From 2005 to 2015, 151 patients were diagnosed and received first treatment at our centre. 87 (56,7%) patients were male. At diagnosis, the median age was 34 (18-88) years. Prevalence of HIV infection was 9,9% (n=15). Among 151 patients, 138 (91,4%) were treated with a curative intention: 12 (8,6%) had early-stage favourable disease; 39 (28,2%) early-stage unfavourable; 87 (63%) advanced stage. As first line approach, 81 (58,7%) were treated with chemotherapy alone and 57 (37,7%) with combined chemotherapy and radiotherapy. The ABVD protocol was the chemotherapy regimen in 122 (88,4%) patients, followed by BEACOPP in 7 (5,1%). Radiotherapy was performed in 60 (41,7%) patients, with Involved Field protocol in 59. Overall Response Rate after first line treatment was 92% for early-stage favourable, 86% for early-stage unfavourable, 71% for advanced-stage. Autologous Transplantation was performed in 17 patients (12,3%), all in context of relapse or refractory disease. The 5-year Overall Survival was 86,3%. Among patients diagnosed throughout reproductive age, 10,4% (n=10) underwent gamete cryopreservation, while 24,4% (n=10) of females in fertile age underwent on GnRH agonists for ovarian protection. The overall incidence of reported treatment attributable toxicities was 57% (n=86). Pulmonary and neuropsychiatric disorders were the most commonly reported, 25,8% (n=39) and 29,8% (n=45), respectively. Pulmonary complications developed independently of previous thoracic radiotherapy exposure (p>0,05). Other reported toxicities were: infertility in 1% (n=1) of individuals in reproductive age; secondary neoplasia in 4,6% (n=7) with median presentation after diagnosis of 36 months; thyroid disorders in 7,9% (n=12), of which 75% (n=9) were exposed to cervical radiotherapy; cardiac complications in 4,6% (n=7), the majority (n=5) was not exposed to mediastinal radiotherapy; cerebrovascular disease developed in 3,3% (n=5).
Conclusion
In our cohort of Hodgkin Lymphoma survivors, chemotherapy and radiotherapy attributable toxicities had a significant prevalence. The short follow-up period and the lack of a fully applied surveillance protocol might be the reason for the lower prevalence of toxicities observed in this cohort, in comparison with the most relevant published studies. The development of surveillance protocols for detection of short and long-term toxicities are of major importance to understand their true impact in overall survival and quality of life of Hodgkin Lymphoma survivors.
Session topic: E-poster
Keyword(s): Comorbidities, Hodgkin's lymphoma, Long-term follow-up, Survival
Type: Eposter Presentation
Background
Hodgkin Lymphoma is highly sensitive to chemotherapy and radiotherapy. Treatment related toxicity is a major concern and have a negative impact on quality of life and overall survival of these patients.
Aims
To evaluate chemotherapy and radiotherapy attributable toxicity in a cohort of Hodgkin Lymphoma survivors.
Methods
We performed a retrospective analysis of a Hodgkin Lymphoma cohort diagnosed and treated in a Portuguese tertiary hospital centre, from 2005 to 2015. The toxicities assessed were: secondary neoplasia, infertility, thyroid, cardiac, pulmonary, cerebrovascular and neuropsychiatric disorders.
Results
From 2005 to 2015, 151 patients were diagnosed and received first treatment at our centre. 87 (56,7%) patients were male. At diagnosis, the median age was 34 (18-88) years. Prevalence of HIV infection was 9,9% (n=15). Among 151 patients, 138 (91,4%) were treated with a curative intention: 12 (8,6%) had early-stage favourable disease; 39 (28,2%) early-stage unfavourable; 87 (63%) advanced stage. As first line approach, 81 (58,7%) were treated with chemotherapy alone and 57 (37,7%) with combined chemotherapy and radiotherapy. The ABVD protocol was the chemotherapy regimen in 122 (88,4%) patients, followed by BEACOPP in 7 (5,1%). Radiotherapy was performed in 60 (41,7%) patients, with Involved Field protocol in 59. Overall Response Rate after first line treatment was 92% for early-stage favourable, 86% for early-stage unfavourable, 71% for advanced-stage. Autologous Transplantation was performed in 17 patients (12,3%), all in context of relapse or refractory disease. The 5-year Overall Survival was 86,3%. Among patients diagnosed throughout reproductive age, 10,4% (n=10) underwent gamete cryopreservation, while 24,4% (n=10) of females in fertile age underwent on GnRH agonists for ovarian protection. The overall incidence of reported treatment attributable toxicities was 57% (n=86). Pulmonary and neuropsychiatric disorders were the most commonly reported, 25,8% (n=39) and 29,8% (n=45), respectively. Pulmonary complications developed independently of previous thoracic radiotherapy exposure (p>0,05). Other reported toxicities were: infertility in 1% (n=1) of individuals in reproductive age; secondary neoplasia in 4,6% (n=7) with median presentation after diagnosis of 36 months; thyroid disorders in 7,9% (n=12), of which 75% (n=9) were exposed to cervical radiotherapy; cardiac complications in 4,6% (n=7), the majority (n=5) was not exposed to mediastinal radiotherapy; cerebrovascular disease developed in 3,3% (n=5).
Conclusion
In our cohort of Hodgkin Lymphoma survivors, chemotherapy and radiotherapy attributable toxicities had a significant prevalence. The short follow-up period and the lack of a fully applied surveillance protocol might be the reason for the lower prevalence of toxicities observed in this cohort, in comparison with the most relevant published studies. The development of surveillance protocols for detection of short and long-term toxicities are of major importance to understand their true impact in overall survival and quality of life of Hodgkin Lymphoma survivors.
Session topic: E-poster
Keyword(s): Comorbidities, Hodgkin's lymphoma, Long-term follow-up, Survival
Abstract: E1147
Type: Eposter Presentation
Background
Hodgkin Lymphoma is highly sensitive to chemotherapy and radiotherapy. Treatment related toxicity is a major concern and have a negative impact on quality of life and overall survival of these patients.
Aims
To evaluate chemotherapy and radiotherapy attributable toxicity in a cohort of Hodgkin Lymphoma survivors.
Methods
We performed a retrospective analysis of a Hodgkin Lymphoma cohort diagnosed and treated in a Portuguese tertiary hospital centre, from 2005 to 2015. The toxicities assessed were: secondary neoplasia, infertility, thyroid, cardiac, pulmonary, cerebrovascular and neuropsychiatric disorders.
Results
From 2005 to 2015, 151 patients were diagnosed and received first treatment at our centre. 87 (56,7%) patients were male. At diagnosis, the median age was 34 (18-88) years. Prevalence of HIV infection was 9,9% (n=15). Among 151 patients, 138 (91,4%) were treated with a curative intention: 12 (8,6%) had early-stage favourable disease; 39 (28,2%) early-stage unfavourable; 87 (63%) advanced stage. As first line approach, 81 (58,7%) were treated with chemotherapy alone and 57 (37,7%) with combined chemotherapy and radiotherapy. The ABVD protocol was the chemotherapy regimen in 122 (88,4%) patients, followed by BEACOPP in 7 (5,1%). Radiotherapy was performed in 60 (41,7%) patients, with Involved Field protocol in 59. Overall Response Rate after first line treatment was 92% for early-stage favourable, 86% for early-stage unfavourable, 71% for advanced-stage. Autologous Transplantation was performed in 17 patients (12,3%), all in context of relapse or refractory disease. The 5-year Overall Survival was 86,3%. Among patients diagnosed throughout reproductive age, 10,4% (n=10) underwent gamete cryopreservation, while 24,4% (n=10) of females in fertile age underwent on GnRH agonists for ovarian protection. The overall incidence of reported treatment attributable toxicities was 57% (n=86). Pulmonary and neuropsychiatric disorders were the most commonly reported, 25,8% (n=39) and 29,8% (n=45), respectively. Pulmonary complications developed independently of previous thoracic radiotherapy exposure (p>0,05). Other reported toxicities were: infertility in 1% (n=1) of individuals in reproductive age; secondary neoplasia in 4,6% (n=7) with median presentation after diagnosis of 36 months; thyroid disorders in 7,9% (n=12), of which 75% (n=9) were exposed to cervical radiotherapy; cardiac complications in 4,6% (n=7), the majority (n=5) was not exposed to mediastinal radiotherapy; cerebrovascular disease developed in 3,3% (n=5).
Conclusion
In our cohort of Hodgkin Lymphoma survivors, chemotherapy and radiotherapy attributable toxicities had a significant prevalence. The short follow-up period and the lack of a fully applied surveillance protocol might be the reason for the lower prevalence of toxicities observed in this cohort, in comparison with the most relevant published studies. The development of surveillance protocols for detection of short and long-term toxicities are of major importance to understand their true impact in overall survival and quality of life of Hodgkin Lymphoma survivors.
Session topic: E-poster
Keyword(s): Comorbidities, Hodgkin's lymphoma, Long-term follow-up, Survival
Type: Eposter Presentation
Background
Hodgkin Lymphoma is highly sensitive to chemotherapy and radiotherapy. Treatment related toxicity is a major concern and have a negative impact on quality of life and overall survival of these patients.
Aims
To evaluate chemotherapy and radiotherapy attributable toxicity in a cohort of Hodgkin Lymphoma survivors.
Methods
We performed a retrospective analysis of a Hodgkin Lymphoma cohort diagnosed and treated in a Portuguese tertiary hospital centre, from 2005 to 2015. The toxicities assessed were: secondary neoplasia, infertility, thyroid, cardiac, pulmonary, cerebrovascular and neuropsychiatric disorders.
Results
From 2005 to 2015, 151 patients were diagnosed and received first treatment at our centre. 87 (56,7%) patients were male. At diagnosis, the median age was 34 (18-88) years. Prevalence of HIV infection was 9,9% (n=15). Among 151 patients, 138 (91,4%) were treated with a curative intention: 12 (8,6%) had early-stage favourable disease; 39 (28,2%) early-stage unfavourable; 87 (63%) advanced stage. As first line approach, 81 (58,7%) were treated with chemotherapy alone and 57 (37,7%) with combined chemotherapy and radiotherapy. The ABVD protocol was the chemotherapy regimen in 122 (88,4%) patients, followed by BEACOPP in 7 (5,1%). Radiotherapy was performed in 60 (41,7%) patients, with Involved Field protocol in 59. Overall Response Rate after first line treatment was 92% for early-stage favourable, 86% for early-stage unfavourable, 71% for advanced-stage. Autologous Transplantation was performed in 17 patients (12,3%), all in context of relapse or refractory disease. The 5-year Overall Survival was 86,3%. Among patients diagnosed throughout reproductive age, 10,4% (n=10) underwent gamete cryopreservation, while 24,4% (n=10) of females in fertile age underwent on GnRH agonists for ovarian protection. The overall incidence of reported treatment attributable toxicities was 57% (n=86). Pulmonary and neuropsychiatric disorders were the most commonly reported, 25,8% (n=39) and 29,8% (n=45), respectively. Pulmonary complications developed independently of previous thoracic radiotherapy exposure (p>0,05). Other reported toxicities were: infertility in 1% (n=1) of individuals in reproductive age; secondary neoplasia in 4,6% (n=7) with median presentation after diagnosis of 36 months; thyroid disorders in 7,9% (n=12), of which 75% (n=9) were exposed to cervical radiotherapy; cardiac complications in 4,6% (n=7), the majority (n=5) was not exposed to mediastinal radiotherapy; cerebrovascular disease developed in 3,3% (n=5).
Conclusion
In our cohort of Hodgkin Lymphoma survivors, chemotherapy and radiotherapy attributable toxicities had a significant prevalence. The short follow-up period and the lack of a fully applied surveillance protocol might be the reason for the lower prevalence of toxicities observed in this cohort, in comparison with the most relevant published studies. The development of surveillance protocols for detection of short and long-term toxicities are of major importance to understand their true impact in overall survival and quality of life of Hodgkin Lymphoma survivors.
Session topic: E-poster
Keyword(s): Comorbidities, Hodgkin's lymphoma, Long-term follow-up, Survival
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