Department of Internal Medicine, College of Medicine, University of South Florida, Tampa, FL.
Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
Clin Lymphoma Myeloma Leuk. 2021 Feb;21(2):132-138. doi: 10.1016/j.clml.2020.08.018. Epub 2020 Aug 27.
Classical Hodgkin lymphoma (cHL) is a curable malignancy, with a complete remission rate of approximately 90%. However, relapse remains a significant cause of mortality. Prognostic factors are useful in guiding therapy. This is a large, single-institution study defining the clinicopathologic features, prognostic factors, and treatment outcomes of patients with cHL.
We reviewed 727 patients with cHL treated at H. Lee Moffitt Cancer Center and Research Institute from 1990 to 2017. Data on demographics, laboratory studies, and disease statuses were collected from the institutional database and electronic medical records. Statistical analyses, overall survival (OS), progression-free survival (PFS), and multivariate analyses were performed.
The median age was 35 years. Fifty-four percent of patients were men; 45.6% had advanced stage disease; 82% were treated with ABVD (doxorubicin hydrochloride [adriamycin], bleomycin sulfate, vincristine, and dacarbazine) as frontline therapy; and 70% achieved complete response. The median PFS after first-line treatment was 16.8 years. The median OS of patients with early stage and advanced stage cHL was 19 and 12.9 years, respectively. Poor prognostic factors for OS included older age, advanced stage disease, presence of B symptoms, and a higher International Prognostic Score.
Despite high cure rates, cHL accounted for the cause of death in 47% of patients who died during follow-up. Prognostic factors, such as age, stage at diagnosis, International Prognostic Score, and B symptoms, are helpful to guide treatment. Outcomes observed in this study are comparable with those reported in previously published studies.
经典型霍奇金淋巴瘤（cHL）是一种可治愈的恶性肿瘤，其完全缓解率约为 90%。然而，复发仍是导致死亡的重要原因。预后因素有助于指导治疗。本研究为大型单中心研究，旨在定义 cHL 患者的临床病理特征、预后因素和治疗结果。
我们回顾了 1990 年至 2017 年在 H. Lee Moffitt 癌症研究中心治疗的 727 例 cHL 患者。从机构数据库和电子病历中收集了人口统计学、实验室研究和疾病状态的数据。进行了统计学分析、总生存期（OS）、无进展生存期（PFS）和多变量分析。
中位年龄为 35 岁。54%的患者为男性；45.6%的患者为晚期疾病；82%的患者一线治疗采用 ABVD（盐酸多柔比星[阿霉素]、博来霉素硫酸酯、长春新碱和达卡巴嗪）；70%的患者达到完全缓解。一线治疗后的中位 PFS 为 16.8 年。早期和晚期 cHL 患者的中位 OS 分别为 19 年和 12.9 年。OS 的不良预后因素包括年龄较大、晚期疾病、B 症状存在和较高的国际预后评分。
尽管治愈率高，但在随访期间死亡的患者中，47%的死亡原因是 cHL。年龄、诊断时的分期、国际预后评分和 B 症状等预后因素有助于指导治疗。本研究观察到的结果与之前发表的研究报告的结果相当。
