Contributions
Abstract: PB2009
Type: Publication Only
Background
Hodgkin Lymphoma (HL) with bulky mediastinal disease represents a unique cohort of patients which pose specific challenges in diagnosis, treatment, and prognosis.
Aims
We aim to analyse the treatment outcome of these patients in Hospital Ampang.
Methods
This is a retrospective analytical study. Data was obtained from Hospital Ampang electronic database. Recruitment started from January 2006 and December 2015.
Results
A total of 77 adult patients with HL with bulky mediastinal disease were identified. All patients were followed up from January 2006 till December 2017. The median age of diagnosis was 25 years (range 14 to 61 years), and 56 % (n=43) were males. 47% (n=36) are of nodular sclerosing (NS) subtype. 95% (n=73) were treated with standard protocol, ABVD, whereas 5% (n=4) were treated with BEACOPP protocol. 51% (n=39) of them have received upfront consolidative radiotherapy. The median follow-up duration was 54 months (range 1 to 137 months). 42% (n= 32) attained complete remission whereas 30% (n= 23) had progression of disease in all patients treated with chemotherapy. Overall survival (OS) rate was 88.9% at 48 months and 83.7% at 60 months in all patients treated with chemotherapy. Progression free survival (PFS) was 75.1% at 24 months and 61.7% at 48 months. Amongst the ABVD cohort, the relapse rate was 23% (n=17), 45% (n=33) needed salvage chemotherapy and 25% (n=18) underwent stem cell transplantation. Among the patients who underwent salvage chemotherapy, 39% (n=13) eventually passed on. Amongst the transplanted patients, the mortality rate was 27% (n=5) due of progression of disease.
Conclusion
Bulky mediastinal HL is a peculiar condition with the outcome determined by the primary treatment. From our cohort, 45% of patients undergoing conventional therapy with ABVD require salvage chemotherapy. This suggest that more intensive chemotherapy should be employed as an initial treatment for better tumour load control and downgrade accordingly based on the interim PET-CT report.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Outcome, Treatment
Abstract: PB2009
Type: Publication Only
Background
Hodgkin Lymphoma (HL) with bulky mediastinal disease represents a unique cohort of patients which pose specific challenges in diagnosis, treatment, and prognosis.
Aims
We aim to analyse the treatment outcome of these patients in Hospital Ampang.
Methods
This is a retrospective analytical study. Data was obtained from Hospital Ampang electronic database. Recruitment started from January 2006 and December 2015.
Results
A total of 77 adult patients with HL with bulky mediastinal disease were identified. All patients were followed up from January 2006 till December 2017. The median age of diagnosis was 25 years (range 14 to 61 years), and 56 % (n=43) were males. 47% (n=36) are of nodular sclerosing (NS) subtype. 95% (n=73) were treated with standard protocol, ABVD, whereas 5% (n=4) were treated with BEACOPP protocol. 51% (n=39) of them have received upfront consolidative radiotherapy. The median follow-up duration was 54 months (range 1 to 137 months). 42% (n= 32) attained complete remission whereas 30% (n= 23) had progression of disease in all patients treated with chemotherapy. Overall survival (OS) rate was 88.9% at 48 months and 83.7% at 60 months in all patients treated with chemotherapy. Progression free survival (PFS) was 75.1% at 24 months and 61.7% at 48 months. Amongst the ABVD cohort, the relapse rate was 23% (n=17), 45% (n=33) needed salvage chemotherapy and 25% (n=18) underwent stem cell transplantation. Among the patients who underwent salvage chemotherapy, 39% (n=13) eventually passed on. Amongst the transplanted patients, the mortality rate was 27% (n=5) due of progression of disease.
Conclusion
Bulky mediastinal HL is a peculiar condition with the outcome determined by the primary treatment. From our cohort, 45% of patients undergoing conventional therapy with ABVD require salvage chemotherapy. This suggest that more intensive chemotherapy should be employed as an initial treatment for better tumour load control and downgrade accordingly based on the interim PET-CT report.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Outcome, Treatment