Unfavorable presentation but comparable outcome: Presentation and outcome of children with nodular lymphocyte predominant Hodgkin lymphoma from India

Prasad, Maya; Narula, Gaurav; Chinnaswamy, Girish; Arora, Brijesh; Shet, Tanuja; Panjwani, Poonam; Sengar, Manju; Laskar, Siddharth; Khanna, Nehal; Banavali, Shripad

doi:10.1002/pbc.27288

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…Types A, C, and E of Fan's classification were the most prevalent types, respectively. The rate of typical morphology varies in different studies ranging between 47 and 78% [7,8,10,23]. Some studies have reported a higher rate of typical morphology than the current results [8,23].…”

Section: Discussioncontrasting

confidence: 59%

“…The rate of typical morphology varies in different studies ranging between 47 and 78% [7,8,10,23]. Some studies have reported a higher rate of typical morphology than the current results [8,23]. Hartmann et al studied 423 NLPHL cases and reported that 72% of their patients showed a typical morphological pattern [7].…”

Section: Discussionmentioning

confidence: 63%

“…In addition, they found that time to relapse correlates with histoarchitectural growth patterns (5.2 vs. 2.8 for typical and variant morphologies, respectively) [19]. Other studies on childhood NLPHL have also reported lower rates of complete response, higher rates of relapse, higher rates of unfavorable presentation, and lower EFS in variant morphology compared with typical morphology [23,24]. The absence of a significant association between survival and histoarchitectural patterns in the current study may be related to the limited sample size as well as the short follow-up period (median follow-up time = 25 months).…”

Section: Discussionmentioning

confidence: 95%

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Histopathological and clinical features of nodular lymphocyte-predominant Hodgkin lymphoma and their impact on prognosis: first report from Iran

et al. 2020

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Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of Hodgkin lymphoma (HL). It shows different histoarchitectural patterns which are reported to be of prognostic significance. This study aimed to investigate the clinicopathological features of NLPHL cases in Shiraz, Iran, and their possible impact on prognosis. Between March 2014 and November 2019, all records for lymphoma were extracted from the electronic files of hospitals affiliated with Shiraz University of Medical Sciences. The slides of all NLPHL cases were extracted and reviewed. Other necessary data was retrieved from hospital records and through direct contact with patients. Among1168 lymphoma cases, 382 were HLs and 19.1% (73) of them were of the NLPHL type. The median age of NLPHL patients was 34 years. Of the patients, 51.5% showed variant patterns, and 11% of them had BM involvement. The variant morphology was significantly associated with BM involvement (p = 0.02). Patients with higher stage tumors had lower OS and PFS rates. Stage, BM involvement, and infra-diaphragmatic involvement were significantly associated with outcomes. The rate of NLPHL and variant morphology seems to be high in our center in Iran. The variant morphology was associated with a higher BM involvement rate but not with OS or PFS. Higher stage, BM, and subdiaphragmatic disease involvement were associated with worse outcomes.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 95%

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Histopathological and clinical features of nodular lymphocyte-predominant Hodgkin lymphoma and their impact on prognosis: first report from Iran

et al. 2020

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“…В части работ, выполненных преимущественно во взрослой популяции, показано, что у пациентов с атипичными паттернами чаще отмечаются неблагоприятное клиническое течение, инициально продвинутая стадия, плохой ответ на проводимую терапию, частое развитие рецидивов по сравнению с пациентами с типичными паттернами [35][36][37][38]. В детской популяции данные работы единичны [39][40][41].…”

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The impact of immunoarchitectural patterns on clinical presentation and response to therapy in children with nodular lymphocyte predominant Hodgkin lymphoma

Senchenko,

Abramov,

Myakova

et al. 2024

Voprosy gematologii/onkologii i immunopatologii v pediatrii

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In recent years, there has been a trend towards de-escalation of therapy in patients with early stages of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) which enables reduction in the frequency of late effects of chemo- and radiation therapy while still maintaining their effectiveness. Patients with stage I NLPHL only require excisional biopsy of lymph nodes. If complete remission cannot be achieved by surgery alone or if patients have stage II NLPHL, 3 cycles of low-dose CVP (cyclophosphamide, vinblastine, prednisolone) chemotherapy are administered. In some cases, patients show incomplete response to therapy with subsequent progression of the disease. Hence, the search for factors of unfavorable clinical course of NLPHL still continues, with an immunoarchitectural pattern potentially being one of them. Here, we aimed to compare clinical features, treatment responses and relapse rates in patients with NLPHL based on the type of an immunoarchitectural pattern. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. In our study, we included a cohort of 49 patients (39 boys, 10 girls) aged 2 to 18 years (median age: 10 years) with diagnosed NLPHL who were divided into 2 groups based on histological features of the disease: typical patterns (n = 21, 42.9 %) and atypical patterns (n = 28, 57.1 %). The two groups were compared using the exact Fisher test. Thirty-three patients had early stage I–II disease at baseline, 14 patients had stage III disease, and 2 patients were diagnosed with stage IV lymphoma affecting the liver and lungs in one case and bones in the other. Clinical characteristics (such as disease stage, B symptoms, the involvement of mediastinal and intra-abdominal lymph nodes) didn’t vary much between the groups, the only exception being the presence/absence of bulky disease (≥ 6 cm) (p = 0.0064). A higher rate of partial response to therapy and disease progression frequency were revealed in the group of atypical patterns (typical: n = 1/21, 4.8 % vs atypical: n = 14/28, 50 %; p = 0.00061). This group was also characterized by a higher relapse rate (typical patterns: n = 1/21, 4.8 % vs atypical: n = 5/28, 17.9 %; p = 0.219). The overall survival rate was 100%, with a median follow-up of 28 (3–108) months. In our study, we revealed a higher incidence of adverse outcomes in the patients with atypical NLPHL patterns compared to the group with typical patterns. The prognostic value of immunoarchitectural patterns needs to be explored more thoroughly, as they have the potential to become one of the criteria for risk stratification of patients with NLPHL.

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Pediatric Hodgkin Lymphoma

Narula,

Parambil,

Dhamne

et al. 2024

Tata Memorial Centre Textbook of Oncology

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Unfavorable presentation but comparable outcome: Presentation and outcome of children with nodular lymphocyte predominant Hodgkin lymphoma from India

Abstract: NLPHL in India has an excellent outcome, despite a higher incidence of unfavorable presentations such as advanced stage disease, B symptoms, and bulky disease. Variant histology is an adverse prognostic factor.

Cited by 5 publications

References 36 publications

Histopathological and clinical features of nodular lymphocyte-predominant Hodgkin lymphoma and their impact on prognosis: first report from Iran

Histopathological and clinical features of nodular lymphocyte-predominant Hodgkin lymphoma and their impact on prognosis: first report from Iran

The impact of immunoarchitectural patterns on clinical presentation and response to therapy in children with nodular lymphocyte predominant Hodgkin lymphoma

Pediatric Hodgkin Lymphoma

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