Treating limited-stage nodular lymphocyte predominant Hodgkin lymphoma similarly to classical Hodgkin lymphoma with ABVD may improve outcome

Savage, Kerry J.; Skinnider, Brian; Al‐Μansour, Mubarak; Sehn, Laurie H.; Gascoyne, Randy D.; Connors, Joseph M.

doi:10.1182/blood-2011-07-365932

Cited by 74 publications

(55 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16,17 In contrast, a study from British Columbia reported that ABVD chemotherapy with or without RT improved outcomes compared with RT alone for limited stage NLPHL. 18 In our study, patients with early stages initially treated with CMT, chemotherapy or immuno-chemotherapy, achieved a good disease control, with a possible benefit over radiotherapy alone, a result that we can relate to a high rate of progression or relapse (26%) after initial radiotherapy. Chemotherapy alone has not been commonly used in adults with early stage NLPHL, 18 and is the main option for patients with advanced stage.…”

Section: Discussionmentioning

confidence: 77%

“…18 In our study, patients with early stages initially treated with CMT, chemotherapy or immuno-chemotherapy, achieved a good disease control, with a possible benefit over radiotherapy alone, a result that we can relate to a high rate of progression or relapse (26%) after initial radiotherapy. Chemotherapy alone has not been commonly used in adults with early stage NLPHL, 18 and is the main option for patients with advanced stage. 7,8,19 In this study, patients with stages III-IV who were initially treated received mainly chemotherapy or immuno-chemotherapy (71.1%), a management which is consistent with the international guidelines.…”

Section: Discussionmentioning

confidence: 77%

See 1 more Smart Citation

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

et al. 2015

View full text Add to dashboard Cite

Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320-1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting ], P=0.0002).Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent. Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

show abstract

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 77%

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In a retrospective report from the BCCA, no relapses were identified (median follow-up, ;5 years) in a subset of 14 patients treated with ABVD alone if an interim PET scan were normal. 45 Although these BCCA results are provocative, it is important to note that the follow-up is rather brief for this disease, which is often associated with late relapse.…”

Section: Chemotherapy Alonementioning

confidence: 97%

“…32,34,44 In contrast, a retrospective study from the BCCA comparing the outcome of 35 patients treated with RT alone with 51 patients treated with chemotherapy (usually ABVD [adriamycin, bleomycin, vinblastine, and dacarbazine]) with or without RT showed an improvement at 10 years in both PFS and OS, using a chemotherapy-based approach. 45 As with all the retrospective studies noted earlier, cautious interpretation is required because of different selection criteria, variable staging procedures, availability of supportive care, and substantial differences in duration of followup for the different therapies.…”

Section: Combined Modality Therapymentioning

confidence: 98%

How I treat nodular lymphocyte predominant Hodgkin lymphoma

Advani¹,

Hoppe

2013

Blood

View full text Add to dashboard Cite

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an uncommon entity that, in contrast to classical Hodgkin lymphoma (cHL), universally expresses CD20, a hallmark of the disease. The majority of the patients present with early-stage disease, and treatment with local radiation provides excellent disease control and overall survival (OS). For locally extensive or advanced stages, paradigms used for cHL have been employed, with similar outcomes. Unlike cHL, late relapses may occur, as well as a propensity to transform to an aggressive B-cell non-Hodgkin lymphoma that underscores the importance of long-term follow-up and rebiopsy at the time of relapse. Deaths caused by NLPHL are uncommon, and in older series, secondary malignancies and other treatment-related toxicities contributed appreciably to overall mortality. Expression of CD20 in NLPHL has led to the evaluation of rituximab as a therapeutic option. Although results with single-agent rituximab in the front-line setting are inferior to conventional therapy, rituximab is a reasonable choice for relapsed disease because of the high overall response rate and excellent tolerability. Most patients have a long OS; therefore, overall goals of therapy should be to minimize the risk for relapse and long-term toxicity.

show abstract

“…A recent retrospective study suggested that treatment with ABVD might improve outcomes compared with radiation or observation. 30,31 T-cell/histiocyte-rich LBCL THRLBCL is a LBCL in which only scattered malignant cells are present in a background of lymphocytes, usually with single or small clusters of histiocytes (Figure 8). 32 The tumor cells may resemble the LP cells of NLPHL, but are more variable in size and shape, or may resemble centroblasts or immunoblasts or even HRS cells.…”

Section: Nodular Lymphocyte Predominant Hlmentioning

confidence: 99%

Shades of gray between large B-cell lymphomas and Hodgkin lymphomas: differential diagnosis and biological implications

Harris

2013

Modern Pathology

View full text Add to dashboard Cite

Hodgkin lymphomas (HLs) are neoplasms of large B cells. Two types are recognized: nodular lymphocyte predominant HL (NLPHL) and classical HL (CHL). In both types, there may be morphological and possibly biological overlap with large B-cell lymphomas (LBCLs) of non-HL types. These include nodular sclerosis CHL and primary mediastinal large B-cell lymphoma; CHL rich in lymphocytes and NLPHL; and NLPHL and T-cell/ histiocyte-rich LBCL. This review covers the defining features of each of these diseases, the borderlines between them, and strategies for differential diagnosis.

show abstract

Treating limited-stage nodular lymphocyte predominant Hodgkin lymphoma similarly to classical Hodgkin lymphoma with ABVD may improve outcome

Cited by 74 publications

References 18 publications

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study

How I treat nodular lymphocyte predominant Hodgkin lymphoma

Shades of gray between large B-cell lymphomas and Hodgkin lymphomas: differential diagnosis and biological implications

Contact Info

Product

Resources

About