Long-term outcomes of patients with relapsed or refractory nodular lymphocyte-predominant Hodgkin lymphoma

This study aimed to evaluate the long-term outcomes of patients with relapsed or refractory (r/r) nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL).

The data showed that first- and second-line therapies are effective over the long-term for these patients.

NLPHL is an uncommon type of Hodgkin lymphoma (HL). It accounts for less than 5% of all HL cases. The initial treatment given to patients is referred to as first-line therapy. This treatment is usually what worked best in clinical trials. Second-line therapy is given after first-line therapy has failed, stopped working, or has side-effects that are not tolerated.

A high number of patients with NLPHL experience relapse (worsening of the disease) or refractory (not responsive) disease after first- and second-line therapy. The information on the long-term outcomes of patients with r/r NLPHL is limited.

69 patients with r/r NLPHL took part in this study. The average follow-up time after the initial diagnosis was 14 years.

41% of patients who received first-line therapy were alive without cancer worsening after 5 years. 96% of these patients were given second-line therapy. Patients were given chemotherapy (41%), biological therapy (20%) such as rituximab (Rituxan), lenalidomide (Revlimid), or brentuximab vedotin (Adcetris), high-dose chemotherapy followed by autologous stem cell transplant (20%) or radiation therapy (15%). 

68% of patients who received second-line therapy were alive without cancer worsening after 5 years. The overall survival rate of these patients at 5 years was 94%.

This study highlights how first- and second-line therapies are effective in the long-term for patients with relapsed or refractory NLPHL.

This study took place in two research centers and had a limited number of patients. The treatment approach and supportive care may have differed in both centers.