Eichenauer Dennis A, Engert Andreas
University of Cologne, First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf.
German Hodgkin Study Group (GHSG), First Department of Internal Medicine, University Hospital Cologne, Cologne, Germany.
Curr Opin Oncol. 2021 Sep 1;33(5):395-399. doi: 10.1097/CCO.0000000000000774.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare B cell-derived malignancy. This review aims at providing an overview of recent developments in the management of NLPHL.
Patients with stage IA NLPHL without risk factors have excellent outcomes. The 8-year progression-free survival (PFS) is roughly 90% and the 8-year overall survival (OS) close to 100% after limited-field radiotherapy (RT) alone. Individuals presenting with early stages other than stage IA without risk factors and intermediate stages have 10-year PFS rates in excess of 70% and 10-year OS rates exceeding 90% when treated with 2 and 4 cycles of ABVD, respectively, followed by consolidation RT. In advanced NLPHL, different protocols such as BEACOPP, ABVD, and R-CHOP have been evaluated retrospectively. However, the optimal approach is undefined. Patients with relapsed NLPHL mostly receive single-agent anti-CD20 antibody treatment or conventional chemotherapy. High-dose chemotherapy and autologous stem cell transplantation are restricted to high-risk patients. NLPHL recurrence is salvaged successfully in the majority of cases.
Patients with NLPHL have a very good prognosis. Treatment differs from classical Hodgkin lymphoma in some situations.
结节性淋巴细胞为主型霍奇金淋巴瘤(NLPHL)是一种罕见的B细胞源性恶性肿瘤。本综述旨在概述NLPHL治疗的最新进展。
无危险因素的IA期NLPHL患者预后良好。单纯局限野放疗(RT)后,8年无进展生存期(PFS)约为90%,8年总生存期(OS)接近100%。无危险因素且表现为除IA期以外的早期和中期患者,分别接受2个周期和4个周期的ABVD方案治疗,随后进行巩固性放疗,其10年PFS率超过70%,10年OS率超过90%。在晚期NLPHL中,已对不同方案如BEACOPP、ABVD和R-CHOP进行了回顾性评估。然而,最佳治疗方法尚未明确。复发的NLPHL患者大多接受单药抗CD20抗体治疗或传统化疗。高剂量化疗和自体干细胞移植仅限于高危患者。大多数情况下,NLPHL复发能成功挽救。
NLPHL患者预后非常好。在某些情况下,其治疗与经典霍奇金淋巴瘤不同。