Universität zu Köln

Borchmann, Sven, Joffe, Erel ORCID: 0000-0002-7883-289X, Moskowitz, Craig H., Zelenetz, Andrew D., Noy, Ariela, Portlock, Carol S., Gerecitano, John F., Batlevi, Connie L., Caron, Philip C., Drullinsky, Pamela, Hamilton, Audrey, Hamlin, Paul A., Jr., Horwitz, Steven M., Kumar, Anita, Matasar, Matthew J., Moskowitz, Alison J., Owens, Colette N., Palomba, M. Lia, Younes, Anas and Straus, David J. (2019). Active surveillance for nodular lymphocyte-predominant Hodgkin lymphoma. Blood, 133 (20). S. 2121 - 2130. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1528-0020

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Abstract

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare subtype of lymphoma that, like other Hodgkin lymphomas, has historically been treated aggressively. However, in most cases, NLPHL has an indolent course, which raises the question of to what extent these patients require aggressive upfront treatment. We describe the management and outcomes of consecutive NLPHL patients diagnosed at Memorial Sloan Kettering Cancer Center (MSK), with a focus on evaluating active surveillance. All patients aged 16 years or older diagnosed and followed at MSK between 1974 and 2016 were included. Treatment outcomes were compared between management with active surveillance and other strategies. We identified 163 consecutive patients who were treated with radiotherapy alone (46%), active surveillance (23%), chemotherapy (16%), combined modality (12%), or rituximab monotherapy (4%). Median follow-up was 69 months. Five-year progression-free survival (PFS), second PFS (PFS2), and overall survival (OS) estimates were 85% (95% confidence interval [CI], 78-90), 97% (95% CI, 92-99), and 99% (95% CI, 95-100), respectively. Only 1 of 7 deaths was lymphoma related. Patients managed with active surveillance had slightly shorter PFS than those receiving any active treatment, with 5-year PFS of 77%(95% CI, 56-89) vs 87%(95% CI, 79-92; P = .017). This difference did not translate into better PFS2 or OS. Only 10 patients managed with active surveillance (27%) eventually required treatment, after a median of 61 months, and none died. NLPHL has an excellent prognosis. Within the limitations of a retrospective analysis, active surveillance is a viable initial management strategy for selected NLPHL patients.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Borchmann, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Joffe, Erel UNSPECIFIED orcid.org/0000-0002-7883-289X UNSPECIFIED Moskowitz, Craig H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zelenetz, Andrew D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Noy, Ariela UNSPECIFIED UNSPECIFIED UNSPECIFIED Portlock, Carol S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerecitano, John F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Batlevi, Connie L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Caron, Philip C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drullinsky, Pamela UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamilton, Audrey UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamlin, Paul A., Jr. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horwitz, Steven M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kumar, Anita UNSPECIFIED UNSPECIFIED UNSPECIFIED Matasar, Matthew J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Moskowitz, Alison J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Owens, Colette N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Palomba, M. Lia UNSPECIFIED UNSPECIFIED UNSPECIFIED Younes, Anas UNSPECIFIED UNSPECIFIED UNSPECIFIED Straus, David J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-148136
DOI:	10.1182/blood-2018-10-877761
Journal or Publication Title:	Blood
Volume:	133
Number:	20
Page Range:	S. 2121 - 2130
Date:	2019
Publisher:	AMER SOC HEMATOLOGY
Place of Publication:	WASHINGTON
ISSN:	1528-0020
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language B-CELL LYMPHOMA; LONG-TERM; ADVANCED-STAGE; PHASE-II; TRANSFORMATION; DISEASE; CANCER; RITUXIMAB; CHILDREN; WATCH Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14813