Stage IV hodgkin's disease: unfavorable prognostic role of liver involvement

D. Pietrasanta, E. D'André, B. Allione, A. Baraldi, L. Bergui, L. Depaoli, F. Di Vito, A. Gallamini, P. Gavarotti, L. Orsucci, M. Fini, G. Guglielmelli, E. Raviolo, D. Rota Scalabrini, F. Salvi, E. Scassa, U. Vitolo, C. Tarella, E. Gallo, A. Levis

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Many patients (pts) with stage IV Hodgkin's disease (HD) treated with conventional chemotherapy regimens do not enter complete remission (CR), or experience a subsequent relapse. However it is difficult to predict those patients are a high risk of failure and could benefit of a more aggressive treatment strategy. AIM OF THE WORK. To analyze the clinical outcome and the prognostic factors of a large group of stage IV patients homogeneously treated with alienated chemotherapy regimens. PATIENTS AND METHODS. From 1982 to 1995 one hundred and thirty stage IV HD pts were treated at diagnosis with 6 to 9 courses of MOPP and ABVD alternated (MMAA) or hybrid (MAMA) regimens. Median age was 39 (range 15-65). Histology patterns were distribuited as follows: LP 2 (2%), NS 60 (46%), MC 46 (35%), LD 13 (10%), undefined 9 (7%). B symptoms were present in 88 cases (68%). The sites of the diffuse extranodal involvement were distributed as follows: bone marrow 56 (43%), liver 38 (29%), lung 28 (21%), other sites 24 (19%). Two concomitant extranodal lesions were present in seventeen pts (13%). Thirty eight pts (29%) were treated according to the MMAA schedule, while ninety two pts (71%) were treated according to the MAMA one. RESULTS. No statistical difference was evident in the clinical outcome between MMAA and MAMA regimens. The final complete remission (CR) rate is 77%; the 15-year relapse free survival, overall survival and event free survival rates were 67%, 59% and 43% respectively. The achievement of the final CR was unfavorably influenced by age over 45 (65% vs. 82%; p=0.01) and by liver involvement (64% vs. 82%; p=0.02). Sex, histology, bulky disease, systemic symptoms, any extranodal disease other than liver involvement and two concomitant extranodal localizations did not affected the final CR rate. The only variables that unfavorably affected the overall survival were age over 45 (48% vs. 67%; p

Original languageEnglish
Issue number11 PART II
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Hematology


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