Clinical and immunohistochemical adverse prognostic factors in Hodgkin lymphoma. Experience in an argentinian institution
Vol. 22 No. 3 (2018), Original articles
Vol. 22 No. 3 (2018)

Clinical and immunohistochemical adverse prognostic factors in Hodgkin lymphoma. Experience in an argentinian institution

Original articles
Published 2019-01-21
M Kalmus
Instituto de Investigaciones Hematológicas “Mariano R. Castex”
M González
Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina
M Narbaitz
Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina
F Metrebian
Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina
S Zabaljauregui
Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina
A Rodríguez
Instituto de Investigaciones Hematológicas “Mariano R. Castex”, Academia Nacional de Medicina
ISSN 2250-8309 (versión en línea) - ISSN 0329-0379 (versión impresa)
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Keywords

Hodgkin lymphoma, prognostic factors, International Prognostic Score

How to Cite

Kalmus, M., González, M., Narbaitz, M., Metrebian, F., Zabaljauregui, S., & Rodríguez, A. (2019). Clinical and immunohistochemical adverse prognostic factors in Hodgkin lymphoma. Experience in an argentinian institution. Journal of Hematology, 22(3), 261–268. Retrieved from https://revistahematologia.com.ar/index.php/Revista/article/view/38
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Abstract

The use of risk stratification tools for an accurate prediction of the outcome in Hodgkin lymphoma (HL) patients at the time of diagnosis is crucial in order to achieve a personalized management, in an era where the goal is to individualize the therapeutic schemes in order to maximize effectiveness and reduce toxicity, scalating treatment in patients who suffer from high-risk diseases and reducing intensity in those with more benign ones. However, most of the classic factors currently used for predicting outcome in patients with HL were described more than 15 years ago and in more recent studies their prognostic value has not been confirmed. The aim of this retrospective observational study was to assess the clinical and immunohistochemical characteristics and their prognostic impact in patients with HL in an Argentinian institution. One hundred and twenty patients were included, with a mean follow up of 72 months. Failure free progression (FFP) and overall survival (OS) at 5 years were 74% and 84%, respectively. The International Prognostic Score (IPS) remained prognostic both for FFP (p = 0,01) and for OS (p < 0,001). However, in the multivariate analysis only 1 variable (age) was significant for the FFP and 3 variables (age, stage and hemoglobin (ASH)) for the OS. A prognostic index composed by these 3 factors (ASH) allowed to discriminate patients -according to the presence of 0, 1 or 2 or more of these factors- in 3 risk groups for both FFP (p = 0,002) and OS (p < 0,001). This simplified prognostic model showed greater predictive power than the IPS and it might be able to identify a very high risk group (patients with 2 or more factors) with a 5 year-FFP and a 5 year-OS below 60%.

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References

1. Cuccaro A, Bartolomei F, Cupelli E y col. Prognostic Factors in Hodgkin Lymphoma. Mediterr J Hematol Infect Dis. Jul 2014; 6(1): e2014053.
2. Bröckelmann PJ, Angelopoulou MK, Vassilakopoulos TP. Prognostic factors in hodgkin lymphoma. Semin Hematol. 2016 Jul;53(3):155-64.
3. Ansell M. Hodgkin lymphoma: 2016 update on diagnosis, risk-stratification, and management. Am J Hematol. 2016; 91(4):435-422.
4. Connors JM. Risk assessment in the management of newly diagnosed classical Hodgkin lymphoma. Blood. 2015; 125(11):1693-1702.
5. Gulley ML, Eagan PA, Quintanilla-Martinez L y col. Epstein-Barr virus DNA is abundant and monoclonal in the Reed-Sternberg cells of Hodgkin’s disease: association with mixed cellularity subtype and Hispanic American ethnicity. Blood. 1994; 83:1595-1602.
6. Evens AM, Hong F, Gordon LI y col. The Efficacy and Tolerability of ABVD and Stanford V in Older Hodgkin Lymphoma Patients: A Comprehensive Analysis from the North American Intergroup Trial E2496. Br J Haematol. 2013; 161(1): 76-86.
7. Massini G, Siemer D, Hohaus S. EBV in Hodgkin Lymphoma. Medit J Hemat Infect Dis. 2009 Nov; 1(2): e2009013.
8. Hohaus S, Massini G, Giachelia M y col. Anemia in Hodgkin’s lymphoma: the role of interleukin-6 and hepcidin. J Clin Oncol. 2010; 28:2538-43.
9. Diefenbach C, Li H, Hong F y col. Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era. BJH. 2015 Sept; 171, 530-538.
10. von Wasielewski R, Mengel M, Fischer R y col. Classical Hodgkin’s Disease, Clinical Impact of the Immunophenotype - Am J Pathol. 1997; 151:1123-1130.
11. Rassidakis GZ, Medeiros LJ, Viviani S y col. CD20 expression in Hodgkin and Reed-Sternberg cells of classical Hodgkin’s disease: associations with presenting features and clinical outcome. Journal of Clinical Oncology. 2002; 20:1278-87.
12. Tzankov A, Krugmann J, Fend F y col. Prognostic significance of CD20 expression in classical Hodgkin lymphoma: a clinicopathological study of 119 cases. Clinical Cancer Research. 2003; 9:1381-6.
13. Portlock CS, Donnelly GB, Qin J, Straus D y col. Adverse prognostic significance of CD20 positive Reed-Sternberg cells in classical Hodgkin’s disease. BJH. 2004;125:701-8.
14. Advani RH, Hoppe RT, Maeda LS y col. Stage I-IIA non-bulky Hodgkin’s lymphoma. Is further distinction based on prognostic factors useful? The Stanford Experience. Int J Radiation Oncology Biol Phys. 2011;81:5,1374-1379.
15. Davison L, Albert-Green A, Tsang R y col. Outcome of patients with early stage Hodgkin lymphoma according to the GHSG and NCIC-CTG risk classification: the Princess Margaret Hospital experience. Haematologica. 2012; 97(s1)- 1110- 17th Congress of the European Hematology Association 2012.
16. Klimm B, Goergen H, Fuchs M, y col. Impact of risk factors on outcomes in early-stage Hodgkin’s lymphoma: an analysis of international staging definitions. Annals of Oncology. 2013; 24:3070-6.
17. Hasenclever D, Volker D. A prognostic score for advanced Hodgkin’s disease. NEJM. 1988; 339:1506-14.
18. Moccia AA, Donaldson J, Chhanabhai M y col. International Prognostic Score in advanced-stage Hodgkin’s lymphoma: altered utility in the modern era. Journal of Clinical Oncology. 2012;30:3383-8.
19. Vassilakopoulos TP, Angelopoulou MK, Siakantaris MP. Validation of the International Prognostic Score in patients with advanced Hodgkin’s lymphoma treated in a single hematology Unit. Haema. 2001; 4:230-5.
20. Guisado P, Reyes Arranz V, Canales MS y col. Stage IV and age over 45 years are the only prognostic factors of the International Prognostic Score for the outcome of advanced Hodgkin lymphoma in the Spanish Hodgkin Lymphoma Study Group series. Leukemia & Lymphoma. May 2012; 53(5): 812-819.
21. Itoh K, Kinoshita T, Watanabe T y col. Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan. Int J Hematol. 2010; 91:446-455.
22. Casasnovas RO, Mounier N, Brice P y col. Plasma cytokine and soluble receptor signature predicts outcome of patients with classical Hodgkin’s lymphoma: a study from the Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol. 2007; 25:1732-40.
23. Blum KA. Upcoming diagnostic and therapeutic developments in classical Hodgkin’s lymphoma. Hematology Am Soc Hematol Educ Program. 2010; 2010:93-100.

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