Primary extranodal cHL: more intensive therapy may be needed

  • Yang M & al.
  • Hematology
  • 1 Dec 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Primary extranodal classical Hodgkin lymphoma (PE-cHL) is associated with significantly shorter remission, increased chance of relapse, and inferior survival vs primary nodal Hodgkin lymphoma (PN-cHL).
  • Elevated lactate dehydrogenase (LDH) and platelets (PLT) are prognostic of inferior PFS (P<.05>

Why this matters

  • Data are scarce regarding this patient subpopulation.

Study design

  • Study to investigate clinical characteristics in 22 patients with PE-cHL vs 274 control patients with PN-cHL.
  • 68.2% of patients had stage IV disease.
  • Median patient age, 30 (range, 15-69) years.
  • Funding: National Natural Science Foundation of China; Beijing Natural Science Foundation; others.

Key results

  • Initial PE-cHL symptoms were generally associated with originating site of disease, but not painless superficial lymph node enlargement.
  • Treatments:
    • 86.4% received ABVD (adriamycin, bleomycin, vincristine, and dacarbazine).
    • 9.1% received BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone).
  • 42.4% 5-year PFS in patients with PE-cHL vs 82.2% with PN-cHL (log rank=18.775; P=.000).
  • 36.4% incidence of relapse or progression in patients with PE-cHL vs 13.1% with PN-cHL (P=.003).
  • 64.6% 5-year OS in patients with PE-cHL vs 97.7% with PN-cHL (log rank=11.485; P=.001).
  • Elevated LDH and elevated PLTs were both prognostic of inferior PFS in PE-cHL (P<.05>

Limitations

  • Retrospective data.

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