Zenzri Yosr, Mokrani Amina, Letaief Feryel, Ayadi Mouna, Mezlini Amel
Medical Oncology Department, Salah Azaiz Institute, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia.
Indian J Hematol Blood Transfus. 2022 Apr;38(2):274-281. doi: 10.1007/s12288-021-01463-4. Epub 2021 Jul 3.
Approximately 5-10% of patients with Hodgkin lymphoma are refractory to initial treatment. The aim of our study was to assess the clinico-epidemiological profile, prognostic factors and treatment outcome. A retrospective study was conducted over a period of 12 years between June 2006 and January 2018 at the oncology department of Salah Azaïz Institute. Thirty-one patients were included. The median age was 27 years with a female predominance (sex ratio = 0.93).The majority had an advanced stage (61%). IGEV regimen was the most commonly used salvage chemotherapy (n = 14). Age above 30 years was predictive of treatment failure after salvage therapy ( = 0.003). IGEV regimen showed better results than ICE protocol in terms of response to salvage therapy ( = 0.048). Seven patients had salvage radiotherapy. Four patients had autologous stem cell transplant. Progressive disease (n = 12) was the main cause of non-eligibility of autologous stem cell tansplant. Overall survival and progression free survival at 3 years were 50% and 5% respectively. The prognostic factors influencing the overall survival were age above 30 years ( = 0.001), advanced Ann Arbor stage before progression ( = 0.02), advanced Ann Arbor stage of refractory Hodgkin lymphoma ( = 0.001), histological subtype ( = 0.001), CD20 expression ( = 0.027) and non-response to salvage therapy ( = 0.004). The prognostic factor influencing progression free survival was the non-response to salvage therapy ( = 0.045). The prognosis of refractory Hodgkin lymphoma remains poor. The current standard secondary treatment consists of combination therapy, usually followed by autologous stem cell transplantat. Innovative therapies are needed to improve the prognosis of refractory Hodgkin lymphoma.
The online version contains supplementary material available at 10.1007/s12288-021-01463-4.
约5%-10%的霍奇金淋巴瘤患者对初始治疗无效。本研究旨在评估临床流行病学特征、预后因素及治疗结果。2006年6月至2018年1月期间，在萨拉赫·阿扎伊兹研究所肿瘤科进行了一项为期12年的回顾性研究。纳入31例患者。中位年龄为27岁，女性占优势（性别比=0.93）。大多数患者处于晚期（61%）。IGEV方案是最常用的挽救性化疗方案（n=14）。30岁以上年龄是挽救治疗后治疗失败的预测因素（=0.003）。在挽救治疗反应方面，IGEV方案比ICE方案显示出更好的结果（=0.048）。7例患者接受了挽救性放疗。4例患者接受了自体干细胞移植。疾病进展（n=12）是自体干细胞移植不符合条件的主要原因。3年总生存率和无进展生存率分别为50%和5%。影响总生存的预后因素为30岁以上年龄（=0.001）、进展前Ann Arbor分期晚期（=0.02）、难治性霍奇金淋巴瘤Ann Arbor分期晚期（=0.001）、组织学亚型（=0.001）、CD20表达（=0.027）及对挽救治疗无反应（=0.004）。影响无进展生存的预后因素为对挽救治疗无反应（=0.045）。难治性霍奇金淋巴瘤的预后仍然很差。当前标准的二线治疗包括联合治疗，通常随后进行自体干细胞移植。需要创新疗法来改善难治性霍奇金淋巴瘤的预后。
在线版本包含可在10.1007/s12288-021-01463-4获取的补充材料。
