Contributions
Abstract: PB2018
Type: Publication Only
Background
Hodgkin lymphoma (HL) is a clonal disease of B-cell origin comprising about 10% of all malignant lymphomas. Classical HL (cHL) includes 4 histological subtypes: lymphocyte rich, nodular sclerosis, mixed cellularity and lymphocyte depleted. Nodular lymphocyte predominant (NLPHL) type is currently a separate entity. Greater than 75% of patients (pts) are cured with current treatment modalities. Prognosis is based on clinical stage, presence of systemic symptoms, presence of bulky disease and treatment rendered.
Aims
In this large single institution database of HL pts, we analyzed demographics, prognostic features, and survival over a 27 year period.
Methods
We evaluated 761 pts with Hodgkin Lymphoma diagnosed between 1990-2017 at Moffitt Cancer Center in this retrospective study. We estimated overall survival (OS) and various clinical and laboratory factors with a potential impact on survival by using the Kaplan Meier curve as well as Cox Proportional Hazards regression. The relationship between clinical features and prognosis was tested using frequencies and either the Chi-square test, Fisher’s Exact test or the Cochran-Armitage trend.
Results
Among all patients, 55.3% were male and the majority were Caucasians (79.2%). Mean age at diagnosis was 38.5 years. 60% of pts were <39 years of age, 31% were 40-64 years old and 9% were 65 and older. Histological subtypes include nodular sclerosis 72.2%, mixed cellularity 19%, lymphocyte rich 3%, lymphocyte depleted 0.7%, and nodular lymphocyte predominant 5.1%. Stage at diagnosis; I-6.9%, II- 47.5%, III 22.7%, IV 22.9%. B-symptoms were present in 50.4% of pts, and 22.6% had bulky disease. 67.2% of pts with advanced stage disease (≥ stage III) presented with B symptoms compared to 36.6% with early stage disease (≤ stage II). Bulky disease revealed no correlation with the stage. There was a significant difference in mean age at diagnosis according histological subtypes; with nodular sclerosis more prominent at younger ages (35.7yrs) compared to lymphocyte depleted (50yrs) (p-value <0.05). The mean time of follow-up was 7.2 years and median survival was 17.8 years with a 5-year OS of 83.1% (CI: 80, 85.6%) and 10-year OS of 70.9% (CI: 66.4, 74.8 %). Survival was significantly different among the age cohorts <39yrs, 40-65 and >65 years with 10-year OS survival of 73.4%, 71.7% and 47.3% respectively (p-value <0.001). Survival was longer in pts with NLPHL histology in comparison to the cHL subtypes. NLPHL had a median survival of 37.4 years with a 5-year OS of 96.9% (CI: 79.8, 99.6%) compared to cHL histology with a median survival of 16.8 years and a 5-year OS of 82.8% (CI: 79.4% vs. 85.9%).
Conclusion
Our data suggests that pts with Hodgkin’s lymphoma have very good long-term outcomes. Significant indicators of poor prognosis include classical histology type, advanced stage at diagnosis, presence of B symptoms, and advanced age. Outcomes based on treatment regimen are in progress.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's disease, Hodgkin's Lymphoma, lymphoma, Outcome
Abstract: PB2018
Type: Publication Only
Background
Hodgkin lymphoma (HL) is a clonal disease of B-cell origin comprising about 10% of all malignant lymphomas. Classical HL (cHL) includes 4 histological subtypes: lymphocyte rich, nodular sclerosis, mixed cellularity and lymphocyte depleted. Nodular lymphocyte predominant (NLPHL) type is currently a separate entity. Greater than 75% of patients (pts) are cured with current treatment modalities. Prognosis is based on clinical stage, presence of systemic symptoms, presence of bulky disease and treatment rendered.
Aims
In this large single institution database of HL pts, we analyzed demographics, prognostic features, and survival over a 27 year period.
Methods
We evaluated 761 pts with Hodgkin Lymphoma diagnosed between 1990-2017 at Moffitt Cancer Center in this retrospective study. We estimated overall survival (OS) and various clinical and laboratory factors with a potential impact on survival by using the Kaplan Meier curve as well as Cox Proportional Hazards regression. The relationship between clinical features and prognosis was tested using frequencies and either the Chi-square test, Fisher’s Exact test or the Cochran-Armitage trend.
Results
Among all patients, 55.3% were male and the majority were Caucasians (79.2%). Mean age at diagnosis was 38.5 years. 60% of pts were <39 years of age, 31% were 40-64 years old and 9% were 65 and older. Histological subtypes include nodular sclerosis 72.2%, mixed cellularity 19%, lymphocyte rich 3%, lymphocyte depleted 0.7%, and nodular lymphocyte predominant 5.1%. Stage at diagnosis; I-6.9%, II- 47.5%, III 22.7%, IV 22.9%. B-symptoms were present in 50.4% of pts, and 22.6% had bulky disease. 67.2% of pts with advanced stage disease (≥ stage III) presented with B symptoms compared to 36.6% with early stage disease (≤ stage II). Bulky disease revealed no correlation with the stage. There was a significant difference in mean age at diagnosis according histological subtypes; with nodular sclerosis more prominent at younger ages (35.7yrs) compared to lymphocyte depleted (50yrs) (p-value <0.05). The mean time of follow-up was 7.2 years and median survival was 17.8 years with a 5-year OS of 83.1% (CI: 80, 85.6%) and 10-year OS of 70.9% (CI: 66.4, 74.8 %). Survival was significantly different among the age cohorts <39yrs, 40-65 and >65 years with 10-year OS survival of 73.4%, 71.7% and 47.3% respectively (p-value <0.001). Survival was longer in pts with NLPHL histology in comparison to the cHL subtypes. NLPHL had a median survival of 37.4 years with a 5-year OS of 96.9% (CI: 79.8, 99.6%) compared to cHL histology with a median survival of 16.8 years and a 5-year OS of 82.8% (CI: 79.4% vs. 85.9%).
Conclusion
Our data suggests that pts with Hodgkin’s lymphoma have very good long-term outcomes. Significant indicators of poor prognosis include classical histology type, advanced stage at diagnosis, presence of B symptoms, and advanced age. Outcomes based on treatment regimen are in progress.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's disease, Hodgkin's Lymphoma, lymphoma, Outcome