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Posted by on Apr 18, 2019 in Hodgkin's lymphoma | 0 comments

In a nutshell

This study aimed to investigate treatments and outcomes for patients with relapsed or unresponsive nodular lymphocyte-predominant Hodgkin lymphoma.

This study concluded that these patients have a good overall prognosis and treatments should be chosen individually.

Some background

Radiotherapy (RT), chemotherapy (CT) and rituximab (Rituxan) are common treatments for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). When these fail to work, relapsed or unresponsive disease occurs. Salvage therapies are those given to treat relapsed/unresponsive disease.  

It is important to evaluate what the optimal treatment for patients with relapsed or unresponsive NLPHL is. 

Methods & findings

This study involved data from 99 patients who had relapsed or unresponsive NLPHL and had received first-line treatment. 91 of these patients developed disease recurrence and 8 patients had primary disease progression. 20% of patients received RT alone as first-line treatment. 74% received CT with or without RT. 6% received single-agent anti-CD20 antibody treatment. Patients were followed for an average of 11.2 years.

The average time to disease recurrence was 3.7 years. 37% of patients received single-agent anti-CD20 antibody treatment or RT alone as salvage therapy. 27% of patients received conventional CT with or without rituximab, with or without RT. 31% received high-dose CT followed by autologous stem cell transplantation (ASCT). 4% of patients received no salvage treatment.

The 5-year progression-free survival (PFS; patients alive 5 years later without cancer worsening) rate was 75.6%. The 5-year PFS was 74.1% after single-agent anti-CD20 antibody treatment or RT alone. The 5-year PFS was 68% after conventional CT with or without anti-CD20 antibody treatment, with or without RT. The 5-year PFS was 84.6% after high dose CT and ASCT.

The 5-year overall survival (OS; patients alive 5 years later) rate was 89.5%. The 5-year OS rate was 97.2% after single-agent anti-CD20 antibody treatment or RT alone. The 5-year OS rate was 77.8% after conventional CT with or without anti-CD20 antibody treatment, with or without RT. The 5-year OS rate was 89.8% after high dose CT and ASCT.

The bottom line

This study concluded that patients with relapsed or unresponsive NLPHL had a good overall prognosis and treatments should be chosen individually.

The fine print

This study included a small number of patients from a German database. Larger studies should be carried out on more different populations.

Published By :

Blood

Date :

Aug 09, 2018

Original Title :

Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group.

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