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Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience

Year 2013, Volume: 2013 Issue: 2, 178 - 185, 01.02.2013
https://doi.org/10.5152/balkanmedj.2012.110

Abstract

Background: Hodgkin's lymphoma (HL) is a B cell lymphoma characterized by the presence of Reed-Sternberg cells. HL comprises 1% of all cancer cases and 14% of all lymphoma cases. Aims: We designed a retrospective study to investigate the clinical features and prognostic factors of HL patients diagnosed at an experienced oncology centre. Study Design: Retrospective study. Methods: Demographic characteristics, histopathological and clinical features, treatment modalities and response to treatment were obtained from hospital records. Dates of initial diagnosis, remission and relapse, last visit and death were recorded for survival analyses. Results: We analysed data of 391 HL patients (61% male, 39% female; mean age 35.7±15.1 years). The most common classical HL histological subtype was nodular sclerosing HL (NSHL) (42.7%). The most common stage was II 50.4%. The most common chemotherapy regimen was doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) (70.6%). Five and 10-year survival rates were 90% and 84%, respectively. Early-stage patients with good prognostic factors had better overall and relapse-free survival rates. The presence of “B” symptoms, albumin level, Eastern Cooperative Oncology Group (ECOG) performance score, and LDH were prognostic factors that affect the survival in both univariate and multivariate analyses. Conclusion: This is the first study that demonstrates the demographic, clinical and prognostic features of HL patients in Turkey, and provides a general picture of the HL patients in our country. Turkish Başlık: Hodgkin's Lenfomanın Klinik Özellikleri ve Prognostik Faktörler: Tek Merkez Deneyimi Anahtar Kelimeler: Hodgkin's lenfoma, tanı, prognoz, tedavi. Arka Plan: Hodgkin's lenfoma (HL) Reed-Sternberg hücreleri ile karakterize B hücreli bir lenfomadır. HL tüm kanser olgularının %1'ini ve tüm lenfomaların %14'ünü oluşturur. Amaç: Biz deneyimli bir onkoloji merkezinde tanı almış HL hastalarına ait klinik özellikleri ve prognostik faktörleri belirlemek için retrospektif bir çalışma planladık. Çalışma Tasarımı: Retrospektif çalışma. Yöntemler: Demografik özellikler, histopatolojik ve klinik özellikler, tedavi modaliteleri ve tedaviye cevap hastane kayıtlarından elde edildi. Sağkalım analizi için tanı, remisyon ve relaps, son vizit ve ölüm tarihleri kaydedildi. Bulgular: 391 (%61 erkek, %39 kadın; ortalama yaş 35.7±15.1 yıl) HL hastasına ait veriler analiz edildi. En sık görülen klasik HL histolojik subtip nodüler sklerozan HL (NSHL) (%42.7) idi. En sık görülen evre %50.4 ile evre II idi. En sık kullanılan kemoterapi rejimi doksorubisin, bleomisin, vinblastin ve dakarbazin (ABVD) (%70.6) idi. 5- ve 10-yıllık sağkalım oranları sırasıyla %90 ve %84'tü. Erken evre iyi prognostik faktörlü hastalar daha iyi genel ve hastalıksız sağkalım oranlarına sahipti. “B” semptomu, albümin düzeyi, Eastern Cooperative Oncology Group (ECOG) performans skoru ve LDH hem tek değişkenli hem de çok değişkenli analizlerde sağkalımı etkileyen prognostik faktörlerdi. Sonuç: Bu çalışma Türkiye'deki HL hastalarının demografik, klinik ve prognostik özelliklerini ortaya koyan ilk çalışmadır ve ülkemizdeki HL hastalarına genel bir bakış sağlamaktadır.

References

  • Ferlay J, Bray F, Pisani P, et al (Eds). GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide. Lyon: IARC Press; 200
  • Pahwa P, Karunanayake CP, Spinelli JJ, Dosman JA, McDuffie HH. Ethnicity and incidence of Hodgkin’s lymphoma in Canadian population. BMC Cancer 2009;9:141-9. [CrossRef]
  • Yung L, Linch D. Hodgkin’s lymphoma. Lancet 2003;361:943-51. [CrossRef]
  • MacLennan KA, Bennett MH, Tu A, Hudson BV, Easterling MJ, Hudson GV, et al. Relationship of histopathologic features to survival and relapse in nodular sclerosing Hodgkin’s disease. A study of 1659 patients. Cancer 1989;64:1686-93. [CrossRef]
  • Al-Salam S, John A, Daoud S, Chong SM, Castella A. Expression of Epstein-Barr virus in Hodgkin’s lymphoma in a population of United Arab Emirates nationals. Leuk Lymphoma 2008;49:17697 [CrossRef]
  • Connors JM. State-of-the-art therapeutics: Hodgkin’s lymphoma. J Clin Oncol 2005;23:6400-8. [CrossRef]
  • Fong D, Steurer M, Greil R, Gunsilius E, Spizzo G, Gastl G, et al. Hodgkin’s lymphoma in Tyrol-a population-based study. Ann Hematol 2009;88:449-56. [CrossRef]
  • McMahon B. Epidemiological evidence on the nature of Hodgkin’s disease. Cancer 1957;10:1045-54. [CrossRef]
  • Gutensohn NM, Shapiro DS. Social class risk factors among children with Hodgkin’s disease. Int J Cancer. 1982;30:433-5. [CrossRef]
  • Coskun HS, Er O, Eser B, et al. Early stage Hodgkin’s disease: Experiences of Erciyes University. Erciyes Med J 2002;24:120-5.
  • Hodgson DC, Gospodarowicz MK. Clinical evaluation and staging of Hodgkin’s lymphoma. In: Hoppe RT, Mauch PM, Armitage JO, Diehl V, Weiss LM (Eds): Hodgkin’s lymphoma. Philadelphia: Lippincott Williams & Wilkins, 2007, pp 123-32.
  • Hoppe RT, Hanlon AL, Hanks GE, Owen JB. Progress in the treatment of Hodgkin’s disease in the United States, 1973 versus 1983. The Patterns of Care Study. Cancer 1994;74:3198-203. [CrossRef]
  • Kennedy BJ, Loeb V Jr, Peterson VM, Donegan WL, Natarajan N, Mettlin C. National survey of patterns of care for Hodgkin’s disease. Cancer 1985;56:2547-56. [CrossRef]
  • Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin’s disease. International Prognostic Factors Project on Advanced Hodgkin’s Disease. N Engl J Med 1998;339:1506-14. [CrossRef]
  • Cosset JM, Henry-Amar M, Noordijk P, et al. The EORTC trials for adult patients with early stage Hodgkin’s disease. A 1997 update; 39th Ann Sci Meet ASTRO, Orlando, FL. 1997.
  • Klimm BD, Engert A, Brillant C, et al. Comparison of BEACOPP and ABVD chemotherapy in intermediate stage Hodgkin’s lymphoma: Results of the fourth interim analysis of the HD 11 trial of GHSG. Proc Am Soc Clin Oncol 2005;23:561.
  • Diehl V, Brilliant C, Engert A, et al. Reduction of combined modality treatment intensity in early stage Hodgkin’s lymphoma, interim analysis of HD10 trial of GHSG. Eur J Haematol 2004;73:37.
  • Diehl V. Dose-escalation study for the treatment of Hodgkin’s disease. The German Hodgkin’s Lymphoma Study Group (GHSG). Ann Hematol 1993;66:139-40. [CrossRef]
  • Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med 2003;348:2386-95. [CrossRef]
  • Sieber M, Bredenfeld H, Josting A, Reineke T, Rueffer U, Koch T, et al. 14-day variant of the bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone regimen in advanced-stage Hodgkin’s lymphoma: results of a pilot study of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 2003;21:1734-9. [CrossRef]
  • Storm HH, Klint A, Tryggvadóttir L, Gislum M, Engholm G, Bray F, et al. Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncol 2010;49:694-712. [CrossRef]
  • Sant M, Capocaccia R, Coleman MP, et al. EUROCARE Working Group. Cancer survival increases in Europe, but international differences remain wide. Eur J Cancer 2001;37:1659-67. [CrossRef] http://seer.cancer.gov/publications/survival/surv_hodgkin.pdf (accessed date: 12 July 2011)
  • Yildiz F, Zengin N, Engin H, Güllü I, Barista I, Caglar M, et al. Prospective study of combined modality treatment or radiotherapy alone in the management of early-stage adult Hodgkin’s disease. Int J Radiat Oncol Biol Phys 2004;60:839-46. [CrossRef]
  • Barista I, Tekuzman G, Baltali E, et al. COPP/ABVD regimens in patients with advance stage Hodgkin’s disease. Turk HematolojiOnkoloji Dergisi 1991;1:40-7.

Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience

Year 2013, Volume: 2013 Issue: 2, 178 - 185, 01.02.2013
https://doi.org/10.5152/balkanmedj.2012.110

Abstract

References

  • Ferlay J, Bray F, Pisani P, et al (Eds). GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide. Lyon: IARC Press; 200
  • Pahwa P, Karunanayake CP, Spinelli JJ, Dosman JA, McDuffie HH. Ethnicity and incidence of Hodgkin’s lymphoma in Canadian population. BMC Cancer 2009;9:141-9. [CrossRef]
  • Yung L, Linch D. Hodgkin’s lymphoma. Lancet 2003;361:943-51. [CrossRef]
  • MacLennan KA, Bennett MH, Tu A, Hudson BV, Easterling MJ, Hudson GV, et al. Relationship of histopathologic features to survival and relapse in nodular sclerosing Hodgkin’s disease. A study of 1659 patients. Cancer 1989;64:1686-93. [CrossRef]
  • Al-Salam S, John A, Daoud S, Chong SM, Castella A. Expression of Epstein-Barr virus in Hodgkin’s lymphoma in a population of United Arab Emirates nationals. Leuk Lymphoma 2008;49:17697 [CrossRef]
  • Connors JM. State-of-the-art therapeutics: Hodgkin’s lymphoma. J Clin Oncol 2005;23:6400-8. [CrossRef]
  • Fong D, Steurer M, Greil R, Gunsilius E, Spizzo G, Gastl G, et al. Hodgkin’s lymphoma in Tyrol-a population-based study. Ann Hematol 2009;88:449-56. [CrossRef]
  • McMahon B. Epidemiological evidence on the nature of Hodgkin’s disease. Cancer 1957;10:1045-54. [CrossRef]
  • Gutensohn NM, Shapiro DS. Social class risk factors among children with Hodgkin’s disease. Int J Cancer. 1982;30:433-5. [CrossRef]
  • Coskun HS, Er O, Eser B, et al. Early stage Hodgkin’s disease: Experiences of Erciyes University. Erciyes Med J 2002;24:120-5.
  • Hodgson DC, Gospodarowicz MK. Clinical evaluation and staging of Hodgkin’s lymphoma. In: Hoppe RT, Mauch PM, Armitage JO, Diehl V, Weiss LM (Eds): Hodgkin’s lymphoma. Philadelphia: Lippincott Williams & Wilkins, 2007, pp 123-32.
  • Hoppe RT, Hanlon AL, Hanks GE, Owen JB. Progress in the treatment of Hodgkin’s disease in the United States, 1973 versus 1983. The Patterns of Care Study. Cancer 1994;74:3198-203. [CrossRef]
  • Kennedy BJ, Loeb V Jr, Peterson VM, Donegan WL, Natarajan N, Mettlin C. National survey of patterns of care for Hodgkin’s disease. Cancer 1985;56:2547-56. [CrossRef]
  • Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin’s disease. International Prognostic Factors Project on Advanced Hodgkin’s Disease. N Engl J Med 1998;339:1506-14. [CrossRef]
  • Cosset JM, Henry-Amar M, Noordijk P, et al. The EORTC trials for adult patients with early stage Hodgkin’s disease. A 1997 update; 39th Ann Sci Meet ASTRO, Orlando, FL. 1997.
  • Klimm BD, Engert A, Brillant C, et al. Comparison of BEACOPP and ABVD chemotherapy in intermediate stage Hodgkin’s lymphoma: Results of the fourth interim analysis of the HD 11 trial of GHSG. Proc Am Soc Clin Oncol 2005;23:561.
  • Diehl V, Brilliant C, Engert A, et al. Reduction of combined modality treatment intensity in early stage Hodgkin’s lymphoma, interim analysis of HD10 trial of GHSG. Eur J Haematol 2004;73:37.
  • Diehl V. Dose-escalation study for the treatment of Hodgkin’s disease. The German Hodgkin’s Lymphoma Study Group (GHSG). Ann Hematol 1993;66:139-40. [CrossRef]
  • Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med 2003;348:2386-95. [CrossRef]
  • Sieber M, Bredenfeld H, Josting A, Reineke T, Rueffer U, Koch T, et al. 14-day variant of the bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone regimen in advanced-stage Hodgkin’s lymphoma: results of a pilot study of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol 2003;21:1734-9. [CrossRef]
  • Storm HH, Klint A, Tryggvadóttir L, Gislum M, Engholm G, Bray F, et al. Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncol 2010;49:694-712. [CrossRef]
  • Sant M, Capocaccia R, Coleman MP, et al. EUROCARE Working Group. Cancer survival increases in Europe, but international differences remain wide. Eur J Cancer 2001;37:1659-67. [CrossRef] http://seer.cancer.gov/publications/survival/surv_hodgkin.pdf (accessed date: 12 July 2011)
  • Yildiz F, Zengin N, Engin H, Güllü I, Barista I, Caglar M, et al. Prospective study of combined modality treatment or radiotherapy alone in the management of early-stage adult Hodgkin’s disease. Int J Radiat Oncol Biol Phys 2004;60:839-46. [CrossRef]
  • Barista I, Tekuzman G, Baltali E, et al. COPP/ABVD regimens in patients with advance stage Hodgkin’s disease. Turk HematolojiOnkoloji Dergisi 1991;1:40-7.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Saadettin Kılıçkap This is me

İbrahim Barışta This is me

Şükran Ülger This is me

İsmail Çelik This is me

Uğur Selek This is me

Ferah Yıldız This is me

Ayşe Kars This is me

Yavuz Özışık This is me

Gülten Tekuzman This is me

Publication Date February 1, 2013
Published in Issue Year 2013 Volume: 2013 Issue: 2

Cite

APA Kılıçkap, S., Barışta, İ., Ülger, Ş., Çelik, İ., et al. (2013). Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience. Balkan Medical Journal, 2013(2), 178-185. https://doi.org/10.5152/balkanmedj.2012.110
AMA Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, Kars A, Özışık Y, Tekuzman G. Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience. Balkan Medical Journal. February 2013;2013(2):178-185. doi:10.5152/balkanmedj.2012.110
Chicago Kılıçkap, Saadettin, İbrahim Barışta, Şükran Ülger, İsmail Çelik, Uğur Selek, Ferah Yıldız, Ayşe Kars, Yavuz Özışık, and Gülten Tekuzman. “Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience”. Balkan Medical Journal 2013, no. 2 (February 2013): 178-85. https://doi.org/10.5152/balkanmedj.2012.110.
EndNote Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, Kars A, Özışık Y, Tekuzman G (February 1, 2013) Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience. Balkan Medical Journal 2013 2 178–185.
IEEE S. Kılıçkap, İ. Barışta, Ş. Ülger, İ. Çelik, U. Selek, F. Yıldız, A. Kars, Y. Özışık, and G. Tekuzman, “Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience”, Balkan Medical Journal, vol. 2013, no. 2, pp. 178–185, 2013, doi: 10.5152/balkanmedj.2012.110.
ISNAD Kılıçkap, Saadettin et al. “Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience”. Balkan Medical Journal 2013/2 (February 2013), 178-185. https://doi.org/10.5152/balkanmedj.2012.110.
JAMA Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, Kars A, Özışık Y, Tekuzman G. Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience. Balkan Medical Journal. 2013;2013:178–185.
MLA Kılıçkap, Saadettin et al. “Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience”. Balkan Medical Journal, vol. 2013, no. 2, 2013, pp. 178-85, doi:10.5152/balkanmedj.2012.110.
Vancouver Kılıçkap S, Barışta İ, Ülger Ş, Çelik İ, Selek U, Yıldız F, Kars A, Özışık Y, Tekuzman G. Clinical Features and Prognostic Factors of Hodgkin’s Lymphoma: A Single Center Experience. Balkan Medical Journal. 2013;2013(2):178-85.