Contributions
Abstract: PB2010
Type: Publication Only
Background
Hodgkin lymphoma is a good prognostic hematological malignancy, early disease has been evaluated in population regardless age, however prognostic factors were not evaluated in adolescents and young adults according to subtype.
Aims
To describe prognostic factors for progression-free survival and overall survival according histologic subtype in AYA population.
Methods
Retrospectively, we reviewed medical records from epidemiology department of Peruvian National Cancer Institute for all classical Hodgkin lymphoma patients aged between 15 and 39. Patients were treated from 2000 to 2014 and received at least 2 cycles of chemotherapy. Survival curves were estimated by Kaplan Meier, the difference was performed by the log-rank test, Cox proportional hazard models were used to identify prognostic factors of survival. Statistical analysis was based on IBM SPSS software version 24.
Results
1037 patients were admitted in the study period, 387 were AYAs, 77 (19.8%) met all criteria. Median age was 25 years (15-39). 39 (50.6%) were male. Nodular sclerosis was the most common subtype with 42 (54.5%) followed by mixed cellularity with 27 (35.1%) and lymphocyte-predominance with 8 (10.4%). According to stages, II stage was more frequent with 69 (89.6%), B symptoms was present in 33 (40.3%). The primary site more common was cervical lymph node with 49 (63.65%). Erythrocyte sedimentation rate (ESR) of 1-30 was seen in 17 patients, 31-50 in 7 patients and 51 or more in 16 patients. Extra lymph node was present in 5 patients, lymph node involvement >2 in 41, bulky disease was present in 8 primary mediastinal lymphomas and in the same number for cervical lymphadenopathy. Regarding the treatment all patients received ABVD chemotherapy with a median of 6 cycles. 56 patients (72.7%) patients received radiotherapy subsequently to chemotherapy. 49 patients (63.6%) achieved complete response, 24 (31.2%) had partial response, 4 (5.2%) had progressive disease. The median progression-free survival was not reached, five-year PFS was 73.3%, univariable analysis (UA) showed statistical significance (p=0.02) for histologic subtype and not achieving a complete response with p<0.01. In the bivariable analysis (BA) the only poor prognostic factor was not achieving a complete response (Hazar ratio (HR) =4.76, 95% confidence interval (CI)=2.87-7.91, p=<0.01). The median overall survival (OS) was not reached, five-year OS was 95.7%. In the UA not achieve a complete response was the only poor prognostic factor with p=<0.01.
Conclusion
Classic Hodgkin lymphoma in early stage has a long-term overall survival. Radiotherapy do not impact neither OS nor PFS. Histologic subtype is a poor prognostic factor for PFS in UA but not in BA. The only poor prognostic factor for both PFS and for OS was not achieving a complete response.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Adolescents, Hodgkin's disease, Prognostic factor, Survival
Abstract: PB2010
Type: Publication Only
Background
Hodgkin lymphoma is a good prognostic hematological malignancy, early disease has been evaluated in population regardless age, however prognostic factors were not evaluated in adolescents and young adults according to subtype.
Aims
To describe prognostic factors for progression-free survival and overall survival according histologic subtype in AYA population.
Methods
Retrospectively, we reviewed medical records from epidemiology department of Peruvian National Cancer Institute for all classical Hodgkin lymphoma patients aged between 15 and 39. Patients were treated from 2000 to 2014 and received at least 2 cycles of chemotherapy. Survival curves were estimated by Kaplan Meier, the difference was performed by the log-rank test, Cox proportional hazard models were used to identify prognostic factors of survival. Statistical analysis was based on IBM SPSS software version 24.
Results
1037 patients were admitted in the study period, 387 were AYAs, 77 (19.8%) met all criteria. Median age was 25 years (15-39). 39 (50.6%) were male. Nodular sclerosis was the most common subtype with 42 (54.5%) followed by mixed cellularity with 27 (35.1%) and lymphocyte-predominance with 8 (10.4%). According to stages, II stage was more frequent with 69 (89.6%), B symptoms was present in 33 (40.3%). The primary site more common was cervical lymph node with 49 (63.65%). Erythrocyte sedimentation rate (ESR) of 1-30 was seen in 17 patients, 31-50 in 7 patients and 51 or more in 16 patients. Extra lymph node was present in 5 patients, lymph node involvement >2 in 41, bulky disease was present in 8 primary mediastinal lymphomas and in the same number for cervical lymphadenopathy. Regarding the treatment all patients received ABVD chemotherapy with a median of 6 cycles. 56 patients (72.7%) patients received radiotherapy subsequently to chemotherapy. 49 patients (63.6%) achieved complete response, 24 (31.2%) had partial response, 4 (5.2%) had progressive disease. The median progression-free survival was not reached, five-year PFS was 73.3%, univariable analysis (UA) showed statistical significance (p=0.02) for histologic subtype and not achieving a complete response with p<0.01. In the bivariable analysis (BA) the only poor prognostic factor was not achieving a complete response (Hazar ratio (HR) =4.76, 95% confidence interval (CI)=2.87-7.91, p=<0.01). The median overall survival (OS) was not reached, five-year OS was 95.7%. In the UA not achieve a complete response was the only poor prognostic factor with p=<0.01.
Conclusion
Classic Hodgkin lymphoma in early stage has a long-term overall survival. Radiotherapy do not impact neither OS nor PFS. Histologic subtype is a poor prognostic factor for PFS in UA but not in BA. The only poor prognostic factor for both PFS and for OS was not achieving a complete response.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Adolescents, Hodgkin's disease, Prognostic factor, Survival