Very late relapses in Hodgkin lymphoma treated with chemotherapy with or without radiotherapy: linear pattern and distinct prognostic factors

Vassilakopoulos, Theodoros; Kravvariti, Evrydiki; Panitsas, Fotios; Angelopoulou, Maria K.; Liaskas, Athanasios; Kontopidou, Flora N.; Yiakoumis, Xanthoula; Variami, Eleni; Dimopoulou, Maria; Siakantaris, Marina P.; Asimakopoulos, John; Arapaki, Maria; Dimou, Maria; Diamantopoulos, Panagiotis; Sachanas, Sotirios; Chatzidimitriou, Chrysovalantou; Belia, Marina; Konstantinou, E.; Boutsikas, Georgios; Petevi, Kyriaki; Kanellopoulos, Anastasios D.; Kokoris, Styliani; Kyrtsonis, Marie‐Christine; Viniou, Nora‐Athina; Lakiotaki, Eleftheria; Tsourouflis, Gerasimos; Korkolopoulou, Penelope; Konstantopoulos, Kostas; Panayiotidis, Panayiotis; Pangalis, Gerassimos A.

doi:10.1038/s41408-022-00674-w

Cited by 10 publications

(9 citation statements)

References 13 publications

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“…Furthermore, to estimate whether the omission of RT could be associated with an increased incidence of very late relapses (beyond 5 years of follow-up), it would be useful to know how many of the five versus 2 PFS events recorded in the CT and CMT arms after the fifth year of follow-up (as concluded by the inspection of the curves) were indeed relapses or deaths in first remission. 7 In conclusion, we believe that adopting the more meaningful Deauville criteria for PET-2 interpretation might help to better implement H10 findings into clinical practice by escalating chemotherapy or omitting RT in the most suitable subgroups.…”

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confidence: 88%

Section: To the Editormentioning

confidence: 99%

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H10: Long-Term Results Could Be Misleading Without an Updated Reading Key for Positron Emission Tomography

Vassilakopoulos,

Liaskas,

Pereyra

et al. 2024

JCO

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mentioning

confidence: 88%

Section: To the Editormentioning

confidence: 99%

H10: Long-Term Results Could Be Misleading Without an Updated Reading Key for Positron Emission Tomography

Vassilakopoulos,

Liaskas,

Pereyra

et al. 2024

JCO

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“… 6 , 7 , 8 In most patients, relapsed disease develops within 2 years after the primary diagnosis, but recurrences may even occur after 5 years. 9 , 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

A significant proportion of classic Hodgkin lymphoma recurrences represents clonally unrelated second primary lymphoma

van Bladel,

Stevens,

Kroeze

et al. 2023

Blood Advances

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Despite high cure rates in classic Hodgkin lymphoma (cHL), relapses are observed. Whether relapsed cHL represents second primary lymphoma or an underlying T-cell lymphoma (TCL) mimicking cHL is under-investigated. To analyze the nature of cHL recurrences, in-depth clonality testing of immunoglobulin (IG) and T-cell receptor (TR) rearrangements was performed in paired cHL diagnosis and recurrences of 60 patients, supported by targeted mutation analysis of lymphoma-associated genes. Clonal IG rearrangements were detected by next-generation sequencing (NGS) in 69/120 (58%) diagnosis and recurrence samples. The clonal relationship could be established in 34 cases, identifying clonally related relapsed cHL in 24/34 patients (71%). Clonally unrelated cHL was observed in 10/34 patients (29%) as determined by IG-NGS clonality assessment, and confirmed by the identification of predominantly mutually exclusive gene mutations in the paired cHL samples. In recurrences of >2 years, ~60% of cHL patients for which the clonal relationship could be established showed a second primary cHL. Clonal TR gene rearrangements were identified in 14/125 samples (11%), and TCL-associated gene mutations were detected in 7/14 samples. Retrospective pathology review with integration of the molecular findings were consistent with an underlying TCL in 5 patients aged >50 years. This study shows that cHL recurrences, especially after 2 years, sometimes represent a new primary cHL or TCL mimicking cHL, as uncovered by NGS-based IG/TR clonality testing and gene mutation analysis. Given the significant therapeutic consequences, molecular testing of a presumed relapse in cHL is crucial for subsequent appropriate treatment strategies adapted to the specific lymphoma presentation.

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“…Basically, relapses can occur because the original treatment was not effective in eliminating the disease, or because the disease has evolved and is resistant to the original treatment. It is important to note that the risk of late Hodgkin disease is also observed in patients who have had advanced stages of the disease and/or who have received certain types of treatment [10][11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Very Late Relapse in Hodgkin Disease: Outcome of Patient Relapsing More Than 24 Years After Primary Chemo- And Radiotherapy on Rare Location

Balkanov

Trajkova

Veljanovska

et al. 2023

AMJ

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Late Hodgkin disease refers to a recurrence of the disease after a period of remission (absence of disease symptoms). It can occur as a de novo (new) malignant neoplasma or as a relapse of the old disease. In some cases, late Hodgkin disease may be a new disorder that is not related to the original disease. This can occur if the patient was not properly treated for the original disease, or if the patient's immune system was compromised and developed something new. In other cases, late Hodgkin disease may be a relapse of the original disease. This means that the disease has come back after a period of remission.We present a case of a 27-year-old male with HD after 24 years of period of complete remission of the initial disease. This very rare relapse of HD was presented on gingivae like an extranodal involvement which is less commonly found than in other lymphomas. The histopathological analysis of the gingivae during the relapse showed presence of another subtype of Hodgkin disease -nodular lymphocyte predominant (NLPHL) on a rare location.It is important for patients to follow their treatment plan closely and to continue to see their healthcare provider for follow-up care after treatment. Our case illustrates that Hodgkin lymphoma can also appear in soft tissue masses such as gingivae and is more refractory to the standard therapeutical approach.

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Very late relapses in Hodgkin lymphoma treated with chemotherapy with or without radiotherapy: linear pattern and distinct prognostic factors

Cited by 10 publications

References 13 publications

H10: Long-Term Results Could Be Misleading Without an Updated Reading Key for Positron Emission Tomography

H10: Long-Term Results Could Be Misleading Without an Updated Reading Key for Positron Emission Tomography

A significant proportion of classic Hodgkin lymphoma recurrences represents clonally unrelated second primary lymphoma

Very Late Relapse in Hodgkin Disease: Outcome of Patient Relapsing More Than 24 Years After Primary Chemo- And Radiotherapy on Rare Location

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