Active surveillance for nodular lymphocyte-predominant Hodgkin lymphoma

被引：56

作者：

Borchmann, Sven ^{[1
,2
,3
]}

Joffe, Erel ^{[1
,4
]}

Moskowitz, Craig H. ^{[1
]}

Zelenetz, Andrew D. ^{[1
]}

Noy, Ariela ^{[1
]}

Portlock, Carol S. ^{[1
]}

Gerecitano, John F. ^{[1
]}

Batlevi, Connie L. ^{[1
]}

Caron, Philip C. ^{[1
]}

Drullinsky, Pamela ^{[1
,5
]}

Hamilton, Audrey ^{[1
]}

Hamlin, Paul A., Jr. ^{[1
]}

Horwitz, Steven M. ^{[1
]}

Kumar, Anita ^{[1
]}

Matasar, Matthew J. ^{[1
]}

Moskowitz, Alison J. ^{[1
]}

Owens, Colette N. ^{[1
,6
]}

Palomba, M. Lia ^{[1
]}

Younes, Anas ^{[1
]}

Straus, David J. ^{[1
]}

机构：

[1] Mem Sloan Kettering Canc Ctr, Dept Med, Lymphoma Serv, 125 York Ave,SR-441B, New York, NY 10065 USA

[2] Univ Cologne, Ctr Mol Med, Else Kroner Forschungskolleg Clonal Evolut Canc, Cologne, Germany

[3] Univ Cologne, Ctr Mol Med, Dept Med 1, Cologne, Germany

[4] Beilinson Med Ctr, Rabin Med Ctr, Davidoff Canc Ctr, Inst Hematol, Petah Tiqwa, Israel

[5] Mem Sloan Kettering Canc Ctr, Breast Med Serv, 1275 York Ave, New York, NY 10021 USA

[6] Mem Sloan Kettering Canc Ctr, Dept Med, Genitourinary Oncol Serv, 1275 York Ave, New York, NY 10021 USA

来源：

BLOOD | 2019年 / 133卷 / 20期

基金：

美国国家卫生研究院;

关键词：

B-CELL LYMPHOMA; LONG-TERM; ADVANCED-STAGE; PHASE-II; TRANSFORMATION; DISEASE; CANCER; RITUXIMAB; CHILDREN; WATCH;

D O I：

10.1182/blood-2018-10-877761

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：2121 / 2129

页数：9

共 35 条

[1] Mature Results of a Phase II Study of Rituximab Therapy for Nodular Lymphocyte-Predominant Hodgkin Lymphoma [J].