Bhurani Dinesh, Nair Reena, Rajappa Senthil, Rao Suparna Ajit, Sridharan Nithya, Boya Rakesh Reddy, Raman Ganapathi S, Menon Hari, Seshachalam Arun, Nimmagadda Ramesh
Department of Haematology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
Department of Haematology, Tata Medical Centre, Kolkata, India.
Front Oncol. 2022 Feb 11;11:799948. doi: 10.3389/fonc.2021.799948. eCollection 2021.
Hodgkin's lymphoma (HL) is one of the most curable malignancies with a 5-year survival of over 80%. Most published literature from low-middle income countries comes from single institute experience.
The OncoCollect Lymphoma group registry was set up in 2017 and has 9 major participating sites across India. Data of newly diagnosed classical HL (CHL) patients, treated between 2011 and 2017, were collected using OncoCollect software. The clinical features, subtypes, prognostic stratification, treatment patterns, response to first-line treatment, and 5-year outcomes were analyzed. All statistical analysis was done using Microsoft R Open statistical software linked to OncoCollect software.
There were 939 newly diagnosed CHL patients with a median age of 38 (range, 18-99) years at presentation. The male-to-female ratio was 2.07:1. Histological subtypes included mixed cellularity, CHL (MC, CHL), nodular sclerosis, CHL (NS, CHL), lymphocyte-rich, CHL (LR, CHL), and lymphocyte-depleted, CHL (LD, CHL), in 60.60%, 26.94%, 9.80%, and 2.66%, respectively. At presentation, 50.43% had B symptoms and 53.35% had advanced disease. 29.71% of advanced-stage patients had high Hodgkin IPI score. 79% and 21% of patients received 1st-line treatment with chemotherapy alone or combined modality treatment with chemotherapy and radiotherapy. The most common first-line chemotherapy was ABVD-based regimen (94.68%). The overall response rate was 93.48%. Complete response rates among early-stage favorable and unfavorable risk groups were 92.73% and 86.79%, and those among advanced-stage low- and high-risk groups were 76.64% and 69.78%, respectively. The median relapse-free follow-up duration was 51 months (IQR 22-69). A significant difference was found in 5-year EFS between the early- and advanced-stage disease 83.53% and 73.55% (p = 0.00087), respectively. Similarly, significant difference was found in EFS among early-stage patients treated with a combination of 4-cycle chemotherapy and radiotherapy vs. chemotherapy alone 88.57% and 66.33% (p = 0.0042), respectively.
In this large cohort from India, survival of patients with HL was comparable to the developed world. With a median follow-up of 51 months, the 5-year EFS and OS of all patients were 78.24% and 83.63%, respectively.
霍奇金淋巴瘤（HL）是最可治愈的恶性肿瘤之一，5年生存率超过80%。大多数来自低收入和中等收入国家的已发表文献来自单一机构的经验。
OncoCollect淋巴瘤组登记处成立于2017年，在印度有9个主要参与站点。使用OncoCollect软件收集了2011年至2017年期间接受治疗的新诊断经典HL（CHL）患者的数据。分析了临床特征、亚型、预后分层、治疗模式、一线治疗反应和5年结局。所有统计分析均使用与OncoCollect软件链接的Microsoft R Open统计软件进行。
有939例新诊断的CHL患者，就诊时中位年龄为38岁（范围18 - 99岁）。男女比例为2.07:1。组织学亚型包括混合细胞型CHL（MC，CHL）、结节硬化型CHL（NS，CHL）、富于淋巴细胞型CHL（LR，CHL）和淋巴细胞消减型CHL（LD，CHL），分别占60.60%、26.94%、9.80%和2.66%。就诊时，50.43%有B症状，53.35%有晚期疾病。29.71%的晚期患者霍奇金IPI评分高。79%和21%的患者接受一线单纯化疗或化疗联合放疗。最常见的一线化疗是以ABVD为基础的方案（94.68%）。总缓解率为93.48%。早期有利和不利风险组的完全缓解率分别为92.73%和86.79%，晚期低风险和高风险组的完全缓解率分别为76.64%和69.78%。无复发生存期的中位随访时间为51个月（IQR 22 - 69）。早期和晚期疾病的5年无事件生存率分别为83.53%和73.55%，差异有统计学意义（p = 0.00087）。同样，在早期接受4周期化疗联合放疗与单纯化疗的患者中，无事件生存率分别为88.57%和66.33%，差异有统计学意义（p = 0.0042）。
在这个来自印度的大型队列中，HL患者的生存率与发达国家相当。中位随访51个月，所有患者的5年无事件生存率和总生存率分别为78.24%和83.63%。
