Therapy of Hodgkin's lymphoma in clinical practice: A retrospective long-term follow-up analysis

Sara Aquino, Marino Clavio, Edoardo Rossi, Luana Vignolo, Maurizio Miglino, Mauro Spriano, Letizia Canepa, Gioacchino Catania, Ivana Pierri, Micaela Bergamaschi, Roberta Gonella, Carlo Marani, Omar Racchi, Marina Cavaliere, Riccardo Goretti, Federico Carbone, Andrea Bruzzone, Rodolfo Tassara, Angelo Michele Carella, Riccardo GhioMarco Gobbi

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Abstract

Treatment of Hodgkin's lymphoma (HL) is perceived to be relatively straightforward. Consequently, patients are not usually referred to hemato-oncologically specialized centres and are treated locally instead. Comprehensive findings beyond prospective controlled trials are therefore lacking. Clinical data of 209 patients who had received a HL diagnosis were collected. A total of 7 patients received radiotherapy (RT) alone (3%), 75 (35%) were treated with a combination of chemotherapy (CT) and RT and 127 patients received CT alone [mainly doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD)]. Complete response (CR) following first-line treat- ment was achieved in 178 patients (85%) and in 195 (93%) after salvage treatment. Favorable disease (p=0.000359), limited- stage disease (p=0.0003), involvement of lymph nodes above the diaphragm (p=0.05) and absence of mediastinal bulky tumor involvement positively affected the CR rate following first-line treatment. Out of the 195 patients that achieved CR, 31 relapsed. Male gender (p=0.043) and age over 45 years (p=0.047) were significantly associated with an increased inci- dence of relapse. Age at diagnosis was the key factor affecting long-term outcome. The event-free survival (EFS) projected at 120 months was 80 and 57% for patients younger and older than 45 years, respectively (p=0.022). The overall survival (OS) projected at 120 months was 92 and 38% for patients younger and older than 45 years, respectively (p=0.00561). A second neoplasia was diagnosed in 8 patients. The development of a tumor in 4 cases (breast, lung and thyroid cancer) was likely RT-related. Only 1 patient not receiving RT developed acute myeloid leukemia. The EFS and OS of the 141 early-stage patients treated with CT + RT (n=62) or with CT alone (n=79) were not statistically different.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalOncology Letters
Volume2
Issue number2
DOIs
Publication statusPublished - Mar 2011

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Keywords

  • Bleomycin
  • Doxorubicin
  • High-dose therapy
  • Hodgkin's lymphoma
  • Relapse
  • Vinblastine and dacarbazine

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Aquino, S., Clavio, M., Rossi, E., Vignolo, L., Miglino, M., Spriano, M., Canepa, L., Catania, G., Pierri, I., Bergamaschi, M., Gonella, R., Marani, C., Racchi, O., Cavaliere, M., Goretti, R., Carbone, F., Bruzzone, A., Tassara, R., Carella, A. M., ... Gobbi, M. (2011). Therapy of Hodgkin's lymphoma in clinical practice: A retrospective long-term follow-up analysis. Oncology Letters, 2(2), 289-295. https://doi.org/10.3892/ol.2011.255