Late relapse of classical Hodgkin lymphoma: an analysis of the German Hodgkin Study Group HD7 to HD12 trials
Purpose: Clinical characteristics, therapeutic approaches, and prognosis of late relapse (LR) in patients with classic Hodgkin lymphoma (cHL) are poorly understood. We performed a comprehensive analysis of LR of Hodgkin lymphoma (LR-HL).MethodsTo estimate the incidence of LR-HL, we retrospectively a...
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| Main Authors: | , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
February 27, 2017
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| In: |
Journal of clinical oncology
Year: 2017, Volume: 35, Issue: 13, Pages: 1444-1450 |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO.2016.71.3289 |
| Online Access: | Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1200/JCO.2016.71.3289 Verlag, kostenfrei, Volltext: http://ascopubs.org/doi/10.1200/JCO.2016.71.3289 
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| Author Notes: | Paul J. Bröckelmann, Helen Goergen, Charlotte Kohnhorst, Bastian von Tresckow, Alden Moccia, Jana Markova, Julia Meissner, Andrea Kerkhoff, Wolf-Dieter Ludwig, Michael Fuchs, Peter Borchmann, and Andreas Engert |
| Summary: | Purpose: Clinical characteristics, therapeutic approaches, and prognosis of late relapse (LR) in patients with classic Hodgkin lymphoma (cHL) are poorly understood. We performed a comprehensive analysis of LR of Hodgkin lymphoma (LR-HL).MethodsTo estimate the incidence of LR-HL, we retrospectively analyzed 6,840 patients with cHL included in the German Hodgkin Study Group trials HD7 to HD12. Patients who experienced a relapse > 5 years into remission were compared with patients in continued remission for > 5 years and with those who experienced a relapse ≤ 5 years after first diagnosis.ResultsWith a median observation time of 10.3 years, 141 incidences of LR-HL were observed. Cumulative incidences at 10, 15, and 20 years rose linearly and were 2.5%, 4.3%, and 6.9%, respectively. The standardized incidence ratio for HL with respect to age- and sex-matched German reference data was 84.5 (95% CI, 71.2 to 99.7). LR-HL was more frequently observed in patients with early-stage favorable than unfavorable or advanced stage at first diagnosis (15-year cumulative incidence, 5.3% v 3.9% and 3.9%, respectively; P = .01). Overall survival from first diagnosis was worse after LR compared with nonrelapse survivors (10-year estimate, 95.8% v 86.1%; hazard ratio, 2.5; 95% CI, 1.7 to 3.5; P < .001). In patients with LR-HL, survival was better compared with 466 patients with earlier relapse (hazard ratio, 0.6; 95% CI, 0.4 to 0.9, P = .01). Forty-four percent and 49% of patients with LR-HL and earlier relapse, respectively, received stem cell transplantations.ConclusionApart from treatment-associated adverse effects, survivors after initially successful therapy for cHL are at an 85-fold risk for recurrence of disease compared with the general German population. After risk-adapted treatment strategies, especially in early-stage favorable HL, regular clinical follow-up is recommended for timely detection of LR-HL. With adequate treatment, prognosis of LR-HL is better compared with early relapses. |
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| Item Description: | Gesehen am 09.08.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1527-7755 |
| DOI: | 10.1200/JCO.2016.71.3289 |