Time to Progression Worse in Nodular Lymphocyte-predominant Hodgkin Lymphoma

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Currently, gaps exist in the understanding of advanced-stage nodular lymphocyte-predominant Hodgkin (NLPHL), as the disease is very rare, according to background information in a study published in the journal Blood. To increase knowledge as well as compare NLPHL with classic Hodgkin lymphoma, researchers conducted a matched pair outcome analysis of 42 patients diagnosed with NLPHL as determined by the Revised European-American Lymphoma/World Health Organization classification, with advanced-stage disease. These patients were then matched in a 1:2 fashion by age, gender, disease stage, decade of diagnosis, and treatment with control patients who had classical Hodgkin lymphoma. Median follow-up was 11.3 years for patients with NLPHL and 10.7 years for classical Hodgkin lymphoma. The researchers found that most patients were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD)-like chemotherapy. Data showed similar 10-year overall survival (OS; P=0.579) and freedom from treatment failure between patients with NLPHL (75%) and those with classical Hodgkin lymphoma (73%; P=.610). Time to progression, however, including development of secondary aggressive lymphoma, was worse for those with NLPHL (10-year survival: 63% vs. 73%). Researchers found a link between worse 10-year time to progression and splenic involvement in those treated with ABVD (48% vs. 71%). Splenic involvement was also associated with a higher cumulative incidence of secondary aggressive lymphoma, suggesting the need for further analysis of cyclophosphamide, doxorubicin, vincritine, and prednisone (CHOP) plus rituximab in this patient population, the researchers concluded. 

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Due to disease rarity, there is limited information regarding the optimal therapy and outcome for patients with advanced-stage nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). The median follow-up was 11.3 years (range, 1.9 to 35.5 years) for NLPHL patients and 10.7 years (range, 1.6 to 26.3 years) for CHL patients....

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