Nogová Lucia, Reineke Thorsten, Brillant Corinne, Sieniawski Michal, Rüdiger Thomas, Josting Andreas, Bredenfeld Henning, Skripnitchenko Roman, Müller Rolf-Peter, Müller-Hermelink Hans-Konrad, Diehl Volker, Engert Andreas
First Department of Internal Medicine, University Hospital Cologne, Kerpenerstr 62, 50924 Cologne, Germany.
J Clin Oncol. 2008 Jan 20;26(3):434-9. doi: 10.1200/JCO.2007.11.8869. Epub 2007 Dec 17.
Lymphocyte-predominant Hodgkin's lymphoma (LPHL) is rare and differs in histologic and clinical presentation from classical Hodgkin's lymphoma (cHL). To shed more light on the prognosis and outcome of LPHL, we reviewed all LPHL patients registered in the German Hodgkin Study Group (GHSG) database, comparing patient characteristics and treatment outcome with cHL patients.
We analyzed retrospectively 8,298 HL patients treated within the GHSG trials HD4 to HD12, of whom 394 had LPHL and 7,904 had cHL.
Complete remission and unconfirmed complete remission after first-line treatment was achieved in 91.6% v 85.9% of patients in early favorable stages, 85.7% v 83.3% of patients in early unfavorable stages, and 76.8% v 77.8% of patients in advanced stages of LPHL compared with cHL, respectively. Tumor control (freedom from treatment failure [FFTF]) for LPHL and cHL patients at a median observation of 50 months was 88% and 82% (P = .0093) and overall survival (OS) was 96% and 92%, respectively (P = .0166). In LPHL patients, negative prognostic factors were advanced stage (P = .0092), Hb less than 10.5 g/dL (P = .0171), and lymphopenia (P = .010) for FFTF. Age >or= 45 years (P = .0125), advanced stage (P = .0153), and Hb less than 10.5 g/dL (P = .0014) were negative prognostic factors for OS.
The better prognosis of LPHL as compared with cHL might allow different treatment strategies, particularly for early-stage LPHL patients.
淋巴细胞为主型霍奇金淋巴瘤（LPHL）较为罕见，其组织学和临床表现与经典型霍奇金淋巴瘤（cHL）不同。为更深入了解LPHL的预后和结局，我们回顾了德国霍奇金淋巴瘤研究组（GHSG）数据库中登记的所有LPHL患者，并将患者特征和治疗结局与cHL患者进行比较。
我们对在GHSG试验HD4至HD12中接受治疗的8298例HL患者进行了回顾性分析，其中394例为LPHL，7904例为cHL。
LPHL与cHL相比，早期有利阶段患者一线治疗后的完全缓解和未确认完全缓解率分别为91.6%对85.9%，早期不利阶段患者分别为85.7%对83.3%，晚期患者分别为76.8%对77.8%。在中位观察期50个月时，LPHL和cHL患者的肿瘤控制（无治疗失败生存期[FFTF]）分别为88%和82%（P = 0.0093），总生存期（OS）分别为96%和92%（P = 0.0166）。在LPHL患者中，FFTF的不良预后因素为晚期（P = 0.0092）、血红蛋白低于10.5 g/dL（P = 0.0171）和淋巴细胞减少（P = 0.010）。年龄≥45岁（P = 0.0125）、晚期（P = 0.0153）和血红蛋白低于10.5 g/dL（P = 0.0014）是OS的不良预后因素。
与cHL相比，LPHL预后较好，这可能允许采用不同的治疗策略，尤其是对于早期LPHL患者。
