Genç Erişkin Klasik Hodgkin Lenfomada Progresyonsuz Sağkalım Ve Erken Yanıt Öngörücülerinin Analizi

Öz

Amaç: Klasik Hodgkin lenfoma (HL) ergen-genç erişkin yaş grubunda (EGE) sık görülen bir malignitedir. Bu yaş grubu diğer yaş gruplarına göre biyolojik, klinik ve psikososyal farklılıklara sahip olduğundan EGE grubu olarak ifade edilmektedir. Biz de bu çalışmayla merkezimizdeki genç erişkin grupta Klasik HL tanılı olgularımızı değerlendirmeyi, ara değerlendirmede tam yanıtın (TY-erken yanıt) ve progresyonsuz sağkalım (PFS) öngörücülerini belirlemeyi amaçladık. Gereç ve Yöntemler: 2015-2023 tarihleri arasında merkezimizde klasik HL tanısı alarak tedavi ve izlemi yapılan 18-39 yaş grubundaki hastalar retrospektif olarak incelendi. Bulgular: 54 hastanın ortanca yaşı 30 yıl ve %53,7’i kadındı. En sık alt tip nodüler sklerozan (%61,1) olup hastaların %40’ı tanıda evre II ve %51,9’u ileri evreydi. Erken evre hastaların %53,8’i olumsuz risk grubundayken ileri evre hastaların %46,4’ve %7,1’i orta ve yüksek riske sahipti. 1. basamak tedavide hastaların %92,6’sına ABVD protokolü uygulanmıştı. Ara değerlendirmede TY oranı %66,1 iken tedavi sonunda TY oranı %88 idi. Ortanca 47,5 aylık izlem sürecinde mortalite oranı %3,7 idi. Ortalama toplam sağkalım süresi 107.407 (3.16) (%95 CI) aydı. Ortalama PFS süresi 83,5 ay olup, erken yanıt sağlanan ve sağlanamayan gruplar arasında istatiksel fark bulunmadı (p= 0.197). PFS ve ara değerlendirmede TY öngörücüleri multivariate analizlerde incelendiğinde anlamlı değişken saptanmadı. Sonuç: Çalışmamızda sonuçlarımız literatürle benzerlik göstermekte olup, tamamına yakınına ABVD protokolü uygulanan hasta grubumuzda sağkalım ve tedavi yanıt oranları da yüz güldürücüdür. Hastaların tedavi yaklaşımı ve izleminde katkı sağlayabilecek PFS ve erken TY öngörücüleri incelenmiş ancak anlamlı değişkenler saptanamamıştır. Bunun yanında erken TY sağlanmasının PFS farkı anlamlı bulunmamıştır.

Anahtar Kelimeler

• Hodgkin lenfoma
• genç erişkin
• progresyonsuz sağkalım
• yanıt

Etik Beyan

Çalışma için 21/10/2024 tarihinde Trakya Üniversitesi Tıp Fakültesi Girişimsel Olmayan Araştırmalar Etik Kurulu’ndan onay alınmıştır. Karar no: 17/09.

Analysis of Predictors of Progression-Free Survival and Early Response in Young Adult Classical Hodgkin Lymphoma

Öz

Objective: Classical Hodgkin lymphoma (HL) is a common malignancy among adolescents and young adults (AYA). As this age group has biological, clinical and psychosocial differences compared to other age groups, it is referred to as the AYA group. The present study aimed to evaluate young adult patients diagnosed with classical HL at our center and identify predictors of complete response (CR) at interim evaluation and progression-free survival (PFS). Material and Method: Patients aged 18-39 years diagnosed with classical HL who were treated and followed up at our centre between 2015 and 2023 were retrospectively analysed. Results: The median age of 54 patients was 30 years and 53,7% were female. The most common subtype was nodular sclerosis (61,1%), with 40% of patients in stage II and 51,9% in advanced stages at diagnosis. Among early-stage patients, 53.8% were categorized as unfavorable risk, whereas 46.4% and 7.1% of advanced-stage patients were classified as intermediate and high risk, respectively. In the first- line treatment, 92,6% of patients were treated with the ABVD protocol. At the interim evaluation, the CR rate was 66,1%, while the CR rate at the end of treatment was 88%. The mortality rate was 3,7% during a median follow-up of 47,5 months. The mean overall survival was 107.407 (3.16) (95% CI) months. The mean PFS was 83,5 months, with no statistically significant difference between the early CR and non-CR groups (p = 0.197). When the predictors of PFS and CR at interim assessment were analysed in multivariate analyses, no significant variables were found. Conclusion: In our study, our results are similar to the literature and the survival and response rates in patient population, almost all of whom were on the ABVD protocol, are also encouraging. Despite analyzing potential predictors of PFS and early CR for guiding treatment and follow-up, no significant factors were identified. Furthermore, achieving early CR did not significantly impact PFS.

Anahtar Kelimeler

• Hodgkin lymphoma
• young adults
• progression-free survival
• response

Etik Beyan

Approval for the study was obtained from the Trakya University Faculty of Medicine Non-Interventional Research Ethics Committee on 21/10/2024. Decision no: 17/09.

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