Evaluation of the Relapse Risk and Survival Rate in Patients with Hodgkin Lymphoma: A Monocentric Experience

Abstract

Background and objectives: Hodgkin lymphoma (HL) is characterized by the presence of malignant Reed Sternberg cells. Although the current curability rate in patients with HL has increased, up to 30% of those in the advanced stages and 5% to 10% of those in limited stages of the disease, relapse. According to the studies, the relapse risk in HL decreases after 2 years. The purpose of this study is to evaluate the relapse risk and event free survival (EFS) in patients with HL treated with Doxorubicin, Bleomycin, Vinblastine and Dacarbazine (ABVD), or treated with Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone (BEACOPP) regimens. Material and methods: In an observational, consecutive-case scenario, 71 patients (median age 32 years; range 16 to 80 years) diagnosed within a 4-year timeframe were enrolled; all patients were treated according to standards of care. The average follow-up duration was 26 months. Results: The risk of relapse, in patients older than 40 years, decreased after 1 year, OR = 0.707 (95% CI 0.506 to 0.988), and 2 years, OR = 0.771 (95% CI 0.459 to 1.295), respectively. Patients in the advanced stages had a higher International Prognostic Score (IPS) (score ≥ 4). The overall survival at 2 years was 57.74% and the disease-specific survival at 2 years was 71.83%. Regardless, the chemotherapy regimen and the EFS time, advanced stage, high IPS and bulky disease were still associated with an increased relapse risk in patients with HL. Conclusions: The use of ABVD chemotherapy regimen followed by 2 years EFS was associated with a reduced relapse risk.

Cytotoxic T-lymphocyte-associated 4 protein expression is associated with a high international prognostic score in advanced-stage classical Hodgkin lymphoma

“…Advanced-stage CHL with higher IPS will have poorer prognosis and higher risk of recurrence or relapse. In contrast, lower IPS indicates a more favourable prognosis; hence, each patient can be treated accordingly [ 6 ].…”

“…These risk factors include age, sex, stage, haemoglobin (Hb), leukocyte count, lymphocyte count and serum albumin level [ 2 – 5 ]. Advanced-stage CHL with a higher IPS has a higher risk of recurrence or relapse [ 6 ]. Advanced-stage CHL with IPS 0–3 shows 83% overall survival and IPS ≥ 4 59% [ 7 ].…”

Multi-Phenotypic Breast Cancer Post-Radiotherapy for Hodgkin Lymphoma: A Case of Secondary Malignancy

“…1 Survival rates for Hodgkin lymphoma (HL) patients have significantly improved over the past few decades due to developments in treatment techniques. 5,6 However, RT's long-term and late effects are becoming more apparent and can be challenging to treat, as survivors live long enough to develop RISM. 1,7 Strikingly, secondary malignancies are the leading cause of death in patients with a history of HL, with survivors having an increased risk of breast cancer 8-fold.…”