Contributions
Abstract: PB1564
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
Hodgkin lymphoma (HL) is a hematologic malignancy with a high rate of curability. Several national and international groups have established management protocols for this disease. Since 1999, The Tunisian group has adopted four versions of the HL national protocol(MDH99, MDH2002, MDH2008, and MDH2015).
Aims
Our study aims to evaluate the therapeutic results of the fourthprotocol: MDH2015.
Methods
Our study is retrospectiveabout73newly diagnosed HL adult patients (<60 years old) treated between December 2015 and June 2020at the hematology department of HediChaker hospital Sfax, Tunisia, according to the MDH2015 protocol. The MDH2015recommends an early assessment of response based on scanography after 2 cycles of chemotherapy in each group. For favorable early stages (G1), ABVD regimen was used:two to three cycles followed by involved field radiation therapy (IFRT). For unfavorable early stages (G2), four cycles of ABVD were usedfollowed byIFRT. An escalation to BEACOPP escalated regimenwas recommended if the response was ≤75% (according to Cheson’s criteria).For the advanced stages and localized stages with bulky mediastinal mass (BMM)(G3), treatment is based on six cycles of BEACOPP escalated regimen. De-escalation to four ABVD cycles is used if the response is ≥ 75%after two cycles.The date of point is in February 2021. Our study determines therapeutic responses, the overall survival (OS), event-free survival (EFS), and factorsthat affect the survivals.
Results
Median age at presentation was 33 years (range 16-57 years). There were 27 females and 46 males (M/F: 1.7). Fifty-three percent (53 %) of patients presented with advanced disease. Distribution by group was: G1(n=4), G2(n=20), and G3(n=49).B-symptoms, more than three sites of involvement, BMM, and peripheral bulky tumor were respectively recorded in 74%, 35.6%, 28.8%, and 45.2% of cases. The CR/CRu rate was 82.2% at the end of treatment. PR was 9.6%. The rest of the patients (8.2%) had stable disease. No progressive disease was noted. With a median follow-up of 37 months, one year and 3-year OS and EFS were respectively 97%, 83% and 81.5%, 74.2%. Therapeutic response at the end of treatment was a predictive adverse prognostic factor for OS (p=0.014) and EFS (p=0.0001) in multivariate analysis.
Conclusion
Our results with the MDH2015 protocol in both localized and advanced stages of the disease are encouraging either in initial therapeutic response or in OS and EFSwhich correlates favorably with previous findings of BEACOPP regimen results in the literature: more than 90% of survival in the first year, and more than 80% in three years.
Keyword(s): Hodgkin's lymphoma, Prognostic groups, Treatment
Abstract: PB1564
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
Hodgkin lymphoma (HL) is a hematologic malignancy with a high rate of curability. Several national and international groups have established management protocols for this disease. Since 1999, The Tunisian group has adopted four versions of the HL national protocol(MDH99, MDH2002, MDH2008, and MDH2015).
Aims
Our study aims to evaluate the therapeutic results of the fourthprotocol: MDH2015.
Methods
Our study is retrospectiveabout73newly diagnosed HL adult patients (<60 years old) treated between December 2015 and June 2020at the hematology department of HediChaker hospital Sfax, Tunisia, according to the MDH2015 protocol. The MDH2015recommends an early assessment of response based on scanography after 2 cycles of chemotherapy in each group. For favorable early stages (G1), ABVD regimen was used:two to three cycles followed by involved field radiation therapy (IFRT). For unfavorable early stages (G2), four cycles of ABVD were usedfollowed byIFRT. An escalation to BEACOPP escalated regimenwas recommended if the response was ≤75% (according to Cheson’s criteria).For the advanced stages and localized stages with bulky mediastinal mass (BMM)(G3), treatment is based on six cycles of BEACOPP escalated regimen. De-escalation to four ABVD cycles is used if the response is ≥ 75%after two cycles.The date of point is in February 2021. Our study determines therapeutic responses, the overall survival (OS), event-free survival (EFS), and factorsthat affect the survivals.
Results
Median age at presentation was 33 years (range 16-57 years). There were 27 females and 46 males (M/F: 1.7). Fifty-three percent (53 %) of patients presented with advanced disease. Distribution by group was: G1(n=4), G2(n=20), and G3(n=49).B-symptoms, more than three sites of involvement, BMM, and peripheral bulky tumor were respectively recorded in 74%, 35.6%, 28.8%, and 45.2% of cases. The CR/CRu rate was 82.2% at the end of treatment. PR was 9.6%. The rest of the patients (8.2%) had stable disease. No progressive disease was noted. With a median follow-up of 37 months, one year and 3-year OS and EFS were respectively 97%, 83% and 81.5%, 74.2%. Therapeutic response at the end of treatment was a predictive adverse prognostic factor for OS (p=0.014) and EFS (p=0.0001) in multivariate analysis.
Conclusion
Our results with the MDH2015 protocol in both localized and advanced stages of the disease are encouraging either in initial therapeutic response or in OS and EFSwhich correlates favorably with previous findings of BEACOPP regimen results in the literature: more than 90% of survival in the first year, and more than 80% in three years.
Keyword(s): Hodgkin's lymphoma, Prognostic groups, Treatment