Real-World Outcomes of Hodgkin Lymphoma: A Multi-Centric Registry From India

Abstract

BackgroundHodgkin’s lymphoma (HL) is one of the most curable malignancies with a 5-year survival of over 80%. Most published literature from low-middle income countries comes from single institute experience.MethodologyThe OncoCollect Lymphoma group registry was set up in 2017 and has 9 major participating sites across India. Data of newly diagnosed classical HL (CHL) patients, treated between 2011 and 2017, were collected using OncoCollect software. The clinical features, subtypes, prognostic stratification, treatment patterns, response to first-line treatment, and 5-year outcomes were analyzed. All statistical analysis was done using Microsoft R Open statistical software linked to OncoCollect software.ResultsThere were 939 newly diagnosed CHL patients with a median age of 38 (range, 18–99) years at presentation. The male-to-female ratio was 2.07:1. Histological subtypes included mixed cellularity, CHL (MC, CHL), nodular sclerosis, CHL (NS, CHL), lymphocyte-rich, CHL (LR, CHL), and lymphocyte-depleted, CHL (LD, CHL), in 60.60%, 26.94%, 9.80%, and 2.66%, respectively. At presentation, 50.43% had B symptoms and 53.35% had advanced disease. 29.71% of advanced-stage patients had high Hodgkin IPI score. 79% and 21% of patients received 1st-line treatment with chemotherapy alone or combined modality treatment with chemotherapy and radiotherapy. The most common first-line chemotherapy was ABVD-based regimen (94.68%). The overall response rate was 93.48%. Complete response rates among early-stage favorable and unfavorable risk groups were 92.73% and 86.79%, and those among advanced-stage low- and high-risk groups were 76.64% and 69.78%, respectively. The median relapse-free follow-up duration was 51 months (IQR 22–69). A significant difference was found in 5-year EFS between the early- and advanced-stage disease 83.53% and 73.55% (p = 0.00087), respectively. Similarly, significant difference was found in EFS among early-stage patients treated with a combination of 4-cycle chemotherapy and radiotherapy vs. chemotherapy alone 88.57% and 66.33% (p = 0.0042), respectively.ConclusionsIn this large cohort from India, survival of patients with HL was comparable to the developed world. With a median follow-up of 51 months, the 5-year EFS and OS of all patients were 78.24% and 83.63%, respectively.

Treatment outcomes in classic Hodgkin lymphoma: 5‐year update from the Brazilian Hodgkin Lymphoma Registry

“…In recent decades, significant advancements have occurred in the treatment of Hodgkin lymphoma (HL) [1]. However, limited data exist regarding HL in low-and middle-income countries (LMIC) [2,3]. The Brazilian Hodgkin Lymphoma Registry was established in 2009 and aims to collect comprehensive information in a prospective cohort of HL patients [4][5][6][7].…”

“…ABVD (doxorubicin [adriamycin), bleomycin, vinblastine, dacarbazine) was the first-line treatment in 1248 (94%) patients. Among those who received ABVD, patients with limited disease received a median of four cycles (2-6), patients with intermediate disease a median of four cycles (2-8), and patients with advanced disease a median of six cycles(1)(2)(3)(4)(5)(6)(7)(8). The median duration of each cycle was 27 days.…”