Clinical presentation and outcome in lymphocyte-predominant Hodgkin's disease.

Abstract

Patients with LPHD have different patterns of presentation, sex and age distribution, and likelihood of occult abdominal disease than patients with nodular-sclerosing (NS) or mixed-cellularity (MC) disease. The median time to relapse for LP patients was later than reported for other histologic subtypes; however, there was no pattern of continuous late relapse. With pathologic staging and standard treatment, mortality from LPHD is low; nearly all deaths have been cardiac- or second tumor-related. This suggests that less aggressive treatment for LPHD might continue to yield excellent results, while perhaps lowering the long-term risk of complications.

European Organization for Research and Treatment of Cancer and Groupe d'Etude des Lymphomes de l'Adulte very favorable and favorable, lymphocyte‐predominant Hodgkin disease

“…Regula et al 18 obtained similar results (10-year RFS and OS rates: 76% and 82%, respectively) in patients with LPHD, most of whom had Stage I-II disease that was treated with radiotherapy alone. In accordance with these findings, Bodis et al 5 reported 10-year RFS and OS rates of 80% and 93%, respectively, in patients with LPHD.…”

“…Because less than 33% of deaths among patients with Stage I-II LPHD are due to Hodgkin disease, compared with 50% of deaths among patients with CHD, 5 and because LPHD uncommonly involves the paraaortic lymph nodes or the spleen on presentation, 4,9,10 some groups 26,27 have suggested that mantle radiotherapy alone is the preferred treatment for patients with VF or F LPHD. 7,28 For example, Backstrand et al 28 in Boston have suggested that mantle irradiation alone may be preferable from a quality-oflife standpoint and may reduce the risk of solid tumors compared with STNI.…”

“…Features that excluded the diagnosis included 1) frequent classic Reed-Sternberg cells; 2) frequent nonlymphoid (eosinophils, neutrophils, and plasma cells) inflammatory background cells; 3) extensive fibrosis; and 4) reactivity of ReedSternberg cells for CD15, and nonreactivity for CD20. 5 Nodular architecture was defined as the presence of rounded zones of small lymphocytes that were detectable on light microscopic examination of hematoxylin and eosin-stained slides. Specimens with focal nodularity that accounted for at least 10% of the involved tissue were classified as nodular.…”

“…Specimens with focal nodularity that accounted for at least 10% of the involved tissue were classified as nodular. 5,18 Diffuse architecture was defined as effacement of nodal architecture with only 1-9% of the architecture showing nodularity by routine histologic or immunologic stain. Patients with specimens that were entirely diffuse were diagnosed with T-cell-rich B-cell lymphoma and were excluded from the study.…”

Nodular Lymphocyte Predominant Hodgkin Lymphoma

“…About two dozen retrospective series have been published in the last three decades characterizing the clinical features of Ͼ1,500 cases of NLPHL (Table 2) [19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. The reliability of clinical observations in many of the early studies, however, is uncertain, as many included patients that would likely now be reclassified as having lymphocyte-rich classical Hodgkin lymphoma (LRCHL) or other diseases.…”