Citations 1
Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG
Binkley, Michael S. , Milgrom, Sarah A. , Dickinson, Michael , Ng, Andrea K. , Roberts, Kenneth B. , Gao, Sarah , Balogh, Alex, Levis, Mario , Casulo, Carla , Stolten, Michael , Specht, Lena , Wright, Christopher M. , Brady, J.L. , Mikhaeel, N. George , Terezakis, Stephanie , Pepa, Roberta Della , Maghfoor, Irfan , Koenig, Julie L. , Jackson, Christopher , Song, Erin J. , Sehgal, Shuchi, Advani, Ranjana H. , Natkunam, Yasodha , Eich, Hans Theodor, Wirth, Andrew, Hoppe, Richard T. , Advani, Ranjana H , Dickinson, Michael , Binkley, Michael Sargent , Specht, Lena , Hoppe, Richard T , Natkunam, Yasodha , Levis, Mario , Rauf, M. Shahzad , Pinnix, Chelsea C. , Tsang, Richard , Ricardi, Umberto , Casulo, Carla , Plastaras, John Peter , Kelsey, Chris R. , Hoppe, Bradford S. , Picardi, Marco , Kirova, Youlia , Akhtar, Saad , Constine, Louis S
Blood | March 25, 2020 | Volume: 135 | Issue: 26 | Pages: 2365-2374
Abstract Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon histologic variant, and the optimal treatment of stage I-II NLPHL is undefined. We conducted a multicenter retrospective study including patients ≥16 years of age with stage I-II NLPHL diagnosed from 1995 through 2018 who underwent all forms of management, including radiotherapy (RT), combined modality therapy (CMT; RT+chemotherapy [CT]), CT, observation after excision, rituximab and RT, and single-agent rituximab. End points were progression-free survival (PFS), freedom from transformation, and overall survival (OS) without statistical comparison between management groups. We identified 559 patients with median age of 39 years: 72.3% were men, and 54.9% had stage I disease. Median follow-up was 5.5 years (interquartile range, 3.1-10.1). Five-year PFS and OS in the entire cohort were 87.1% and 98.3%, respectively. Primary management was RT alone (n = 257; 46.0%), CMT (n = 184; 32.9%), CT alone (n = 47; 8.4%), observation (n = 37; 6.6%), rituximab and RT (n = 19; 3.4%), and rituximab alone (n = 15; 2.7%). The 5-year PFS rates were 91.1% after RT, 90.5% after CMT, 77.8% after CT, 73.5% after observation, 80.8% after rituximab and RT, and 38.5% after rituximab alone. In the RT cohort, but not the CMT cohort, variant immunoarchitectural pattern and number of sites >2 were associated with worse PFS (P < .05). Overall, 21 patients (3.8%) developed large-cell transformation, with a significantly higher transformation rate in those with variant immunoarchitectural pattern (P = .049) and number of involved sites >2 (P = .0006). OS for patients with stage I-II NLPHL was excellent after all treatments.