Long-term outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma.

This study evaluated the long-term outcomes of radiation, chemotherapy, or both for the treatment of patients with nodular lymphocyte-predominant Hodgkin’s lymphoma (NLPHL). The data showed that the overall survival was excellent regardless of treatment type.

NLPHL is an uncommon type of Hodgkin lymphoma (HL). It accounts for around 5% of HL cases. Most patients with NLPHL have early-stage (stage 1 or 2) disease. A variety of therapy approaches are used to treat these patients. Surgery, radiation, and rituximab (Rituxan) with or without chemotherapy are commonly used. 

Most patients respond well to initial treatment. Still, a high number of patients with NLPHL experience relapse (worsening of the disease) or refractory (not responsive) disease after initial treatment. The information on treatment, management, and long-term outcomes of patients with r/r NLPHL is limited.

This study involved 200 patients with r/r NLPHL. 100 patients received only chemotherapy. 13 patients received only RT. 68 patients received chemotherapy + RT. 16 patients underwent surgery. 2 patients only received rituximab. 87% of all chemotherapy was ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) regimen. The average follow-up time was 60 months.

82% of the patients had complete disappearance of the cancer and 5.5% of the patients had tumor shrinkage. 10.5% of the patients had disease worsening. 94.8% of all patients were alive after 5 years and 92.4% after 10 years. 

For patients with stage I-II, 97.7% were alive after 5 and 10 years. For those with stage III-IV, 94.8% were alive after 5 years and 92.4% after 10 years. In patients with stage I-II, survival rate without complications from the disease after 5 years was better for patients who had chemotherapy and RT compared to chemotherapy alone (83.3% vs 60%).

This study concluded that the overall survival for patients with NLPHL was excellent and independent of treatment type. In patients with early stages, treatment failure was less common with chemotherapy + RT combination.

This study looked back in time at medical records. This study included patients in the Middle East only, so these results may not apply to all patients. Larger studies should be carried out on more different populations.