Encouraging activity for R-CHOP in advanced stage nodular lymphocyte-predominant Hodgkin lymphoma
| Autor: | Jason R. Westin, Amy Rich, Francesco Turturro, Chao Ming Lai, Sarah A. Milgrom, Yasuhiro Oki, Nathan Fowler, Peter McLaughlin, Chan Yoon Cheah, Michael L. Wang, Loretta J. Nastoupil, Sandra B. Horowitz, Felipe Samaniego, Jorge E. Romaguera, Luis Fayad, Bouthaina S. Dabaja, Chelsea C. Pinnix, L. Jeffrey Medeiros, Michelle A. Fanale, Maria Alma Rodriguez, Hun J. Lee, Anas Younes, Fredrick B. Hagemeister, Sattva S. Neelapu |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Vincristine Time Factors Cyclophosphamide Adolescent Immunology Biochemistry Gastroenterology Disease-Free Survival 03 medical and health sciences Antibodies Monoclonal Murine-Derived 0302 clinical medicine Prednisone Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Cumulative incidence Survival rate Aged Retrospective Studies business.industry Retrospective cohort study Cell Biology Hematology Middle Aged Chemotherapy regimen Hodgkin Disease Surgery Survival Rate Doxorubicin 030220 oncology & carcinogenesis Rituximab Female business 030215 immunology medicine.drug Follow-Up Studies |
| Zdroj: | Blood. 130(4) |
| ISSN: | 1528-0020 |
| Popis: | Nodular lymphocyte Hodgkin lymphoma (NLPHL) is a rare disease for which the optimal therapy is unknown. We hypothesized that rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) could decrease rates of relapse and transformation. We retrospectively reviewed patients with NLPHL diagnosed between 1995 and 2015 confirmed by central pathologic review. Fifty-nine had sufficient treatment and follow-up data for analysis. We described progression-free survival (PFS), overall survival (OS), and histologic transformation according to treatment strategy and explored prognostic factors for PFS and OS. The median age at diagnosis was 41 years; 75% were male, and 61% had a typical growth pattern. Twenty-seven patients were treated with R-CHOP with an overall response rate of 100% (complete responses 89%). The median follow-up was 6.7 years, and the estimated 5- and 10-year PFS rates for patients treated with R-CHOP were 88.5% (95% confidence interval [CI], 68.4% to 96.1%) and 59.3 (95% CI, 25.3% to 89.1%), respectively. Excluding patients with histologic transformation at diagnosis, the 5-year cumulative incidence of histologic transformation was 2% (95% CI, 87% to 100%). No patient treated with R-CHOP experienced transformation. A high-risk score from the German Hodgkin Study Group was adversely prognostic for OS (P = .036), whereas male sex and splenic involvement were adversely prognostic for PFS (P = .006 and .002, respectively) but not OS. Our data support a potential role for R-CHOP in patients with NLPHL. Larger prospective trials are needed to define the optimal chemotherapy regimen. |
| Databáze: | OpenAIRE |
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