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SURVIVAL ANALYSIS OF PATIENTS WITH CLASSICAL HODGKIN´S LYMPHOMA TREATED WITH ABVD: RESULTS FROM TWO REFERRAL CENTERS IN MEXICO CITY.
Author(s):
Gladys Patricia Agreda-Vásquez
,
Gladys Patricia Agreda-Vásquez
Affiliations:
Department of Hematology and Oncology,Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City,Mexico
Ana Florencia Ramírez-Ibarguen
,
Ana Florencia Ramírez-Ibarguen
Affiliations:
Department of Hematology,Instituto Nacional de Cancerología,Mexico City,Mexico
Erick Crespo-Solís
,
Erick Crespo-Solís
Affiliations:
Department of Hematology and Oncology,Hospital Regional de Alta Especialidad de Ciudad Victoria,Victoria,Mexico
María Silvia Rivas-Vera
María Silvia Rivas-Vera
Affiliations:
Department of Hematology,Instituto Nacional de Cancerología, Mexico City,Mexico
(Abstract release date: 05/18/17) EHA Library. Crespo-Solís E. 05/18/17; 182580; PB1866
Erick Crespo-Solís
Erick Crespo-Solís
Contributions
PDF Abstract
Abstract

Abstract: PB1866

Type: Publication Only

Background

Classical Hodgkin´s lymphoma (cHL) is a neoplastic disease with a favorable prognosis since 85% of patients can be considered cured with current treatment strategies. Combined chemotherapy with Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) has been the standard therapy for over 20 years. Epidemiological information and the regimen´s results as first-line therapy in Mexico are limited.

Aims
The aim of this study was to conduct a survival analysis in adult patients from two referral centers in Mexico City.

Methods
This is a retrospective analysis of all patients with cHL treated at the Instituto Nacional de Cancerología and the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, between 2009 and 2013. The study was approved by the local Ethics Committee.

Results

We included a total of 193 patients with a de novo diagnosis and initially treated with ABVD: 60.6% of cases were male, with a median age of 36 years (17-81 years), 71.5% were diagnosed in late clinical stages (CS). The most frequent histopathological subtypes were: nodular sclerosis and mixed cellularity (46.6% and 40.9%; respectively).
The observed overall response rate (RR) was 85.7% [Complete response (CR) was 78.2%]. The RR was 90% in early CS vs. 83.8% in late CS (CR rate was 84% vs. 75.8%; respectively, p=0.23). Univariate analysis by logistic regression in the early CS group revealed that having a Lymphocyte:Monocyte ratio < 1 presents an unfavorable tendency to achieve CR [OR 0.150 (95%CI 0.018-1.274; p=0.082)]. In the group in late CS, we found that the lymphocyte percentage tended to favor CR [OR 1.048 (95%CI 0.994-1.105; p=0.081)] and the opposite was observed in terms of the absolute monocyte count [OR 0.999 (95%CI 0.998-1.000; p=0.082)].
Median follow-up was 35 months (0-96 months), 10.9% of cases had died at last follow-up, and median overall survival (OS) of the entire cohort had not been reached at the time of analysis (5-year OS, 87.1%). However, at the time of this analysis, the group of patients in complete remission had a greater OS than the group that did not achieve CR (p=0.0001). With Cox multivariate analysis of OS according to CS, we detected that in the group in early CS, none of the analyzed factors were significant while in the late CS group, age > 45 years was an independent risk factor [HR 6.9 (95%CI 1.80-26.60; p=0.005)] and achieving CR had a protective effect [HR 0.02 (95%CI 0.004-0.108; p=0.0001)].

Conclusion
Although OS medians had not been reached at the time of analysis, it is noteworthy that CR (84%) in early CS is lower than that reported in the literature and no related prognostic factor has been identified. The role of lymphocytes and monocytes may prove to be significant in larger series with a longer follow-up.

Session topic: 17. Hodgkin lymphoma - Clinical

Keyword(s): Survival, Hodgkin's Lymphoma

Abstract: PB1866

Type: Publication Only

Background

Classical Hodgkin´s lymphoma (cHL) is a neoplastic disease with a favorable prognosis since 85% of patients can be considered cured with current treatment strategies. Combined chemotherapy with Adriamycin, Bleomycin, Vinblastine and Dacarbazine (ABVD) has been the standard therapy for over 20 years. Epidemiological information and the regimen´s results as first-line therapy in Mexico are limited.

Aims
The aim of this study was to conduct a survival analysis in adult patients from two referral centers in Mexico City.

Methods
This is a retrospective analysis of all patients with cHL treated at the Instituto Nacional de Cancerología and the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, between 2009 and 2013. The study was approved by the local Ethics Committee.

Results

We included a total of 193 patients with a de novo diagnosis and initially treated with ABVD: 60.6% of cases were male, with a median age of 36 years (17-81 years), 71.5% were diagnosed in late clinical stages (CS). The most frequent histopathological subtypes were: nodular sclerosis and mixed cellularity (46.6% and 40.9%; respectively).
The observed overall response rate (RR) was 85.7% [Complete response (CR) was 78.2%]. The RR was 90% in early CS vs. 83.8% in late CS (CR rate was 84% vs. 75.8%; respectively, p=0.23). Univariate analysis by logistic regression in the early CS group revealed that having a Lymphocyte:Monocyte ratio < 1 presents an unfavorable tendency to achieve CR [OR 0.150 (95%CI 0.018-1.274; p=0.082)]. In the group in late CS, we found that the lymphocyte percentage tended to favor CR [OR 1.048 (95%CI 0.994-1.105; p=0.081)] and the opposite was observed in terms of the absolute monocyte count [OR 0.999 (95%CI 0.998-1.000; p=0.082)].
Median follow-up was 35 months (0-96 months), 10.9% of cases had died at last follow-up, and median overall survival (OS) of the entire cohort had not been reached at the time of analysis (5-year OS, 87.1%). However, at the time of this analysis, the group of patients in complete remission had a greater OS than the group that did not achieve CR (p=0.0001). With Cox multivariate analysis of OS according to CS, we detected that in the group in early CS, none of the analyzed factors were significant while in the late CS group, age > 45 years was an independent risk factor [HR 6.9 (95%CI 1.80-26.60; p=0.005)] and achieving CR had a protective effect [HR 0.02 (95%CI 0.004-0.108; p=0.0001)].

Conclusion
Although OS medians had not been reached at the time of analysis, it is noteworthy that CR (84%) in early CS is lower than that reported in the literature and no related prognostic factor has been identified. The role of lymphocytes and monocytes may prove to be significant in larger series with a longer follow-up.

Session topic: 17. Hodgkin lymphoma - Clinical

Keyword(s): Survival, Hodgkin's Lymphoma

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