Journal Article

DKFZ-2023-01643

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Interim PET-guided treatment for early-stage NLPHL: a subgroup analysis of the randomized GHSG HD16 and HD17 studies.

Eichenauer, D. A. ; Bühnen, I. ; Baues, C. ; Kobe, C. ; Kaul, H. ; Greil, R. ; Moccia, A. ; Zijlstra, J. M. ; Hertenstein, B. ; Topp, M. S. ; Just, M. ; von Tresckow, B.DKFZ* ; Eich, H.-T. ; Fuchs, M. ; Dietlein, M. ; Hartmann, S. ; Engert, A. ; Borchmann, P.

2023
American Society of Hematology Washington, DC

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Please use a persistent id in citations: doi:10.1182/blood.2023019939

Abstract: The optimal first-line treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) diagnosed in early stages is largely undefined. We, therefore, analyzed 100 NLPHL patients treated in the randomized HD16 (early-stage favorable; n = 85) and HD17 (early-stage unfavorable; n = 15) studies. These studies investigated the omission of consolidation radiotherapy (RT) in patients with a negative interim positron emission tomography (iPET) (ie, Deauville score <3) after chemotherapy (HD16: 2× doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]; HD17: 2× escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [BEACOPP] plus 2× ABVD). Patients with NLPHL treated in the HD16 and HD17 studies had 5-year progression-free survival (PFS) rates of 90.3% and 92.9%, respectively. Thus, the 5-year PFS did not differ significantly from that of patients with classical Hodgkin lymphoma treated within the same studies (HD16: P = .88; HD17: P = .50). Patients with early-stage favorable NLPHL who had a negative iPET after 2× ABVD and did not undergo consolidation RT tended to have a worse 5-year PFS than patients with a negative iPET who received consolidation RT (83% vs 100%; P = .05). There were 10 cases of NLPHL recurrence. However, no NLPHL patient died during follow-up. Hence, the 5-year overall survival rate was 100%. Taken together, contemporary Hodgkin lymphoma-directed treatment approaches result in excellent outcomes for patients with newly diagnosed early-stage NLPHL and, thus, represent valid treatment options. In early-stage favorable NLPHL, consolidation RT appears necessary after 2× ABVD to achieve the optimal disease control irrespective of the iPET result.

Keyword(s): Humans (MeSH) ; Hodgkin Disease: diagnostic imaging (MeSH) ; Hodgkin Disease: drug therapy (MeSH) ; Bleomycin: adverse effects (MeSH) ; Doxorubicin (MeSH) ; Dacarbazine (MeSH) ; Vinblastine (MeSH) ; Antineoplastic Combined Chemotherapy Protocols: adverse effects (MeSH) ; Cyclophosphamide (MeSH) ; Vincristine: adverse effects (MeSH) ; Positron-Emission Tomography: methods (MeSH) ; Prednisone (MeSH) ; Bleomycin ; Doxorubicin ; Dacarbazine ; Vinblastine ; Cyclophosphamide ; Vincristine ; Prednisone

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2023

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 20 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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