Singuluri Lakshmi Sandhya, Jayachandran Perumal Kalaiyarasi, Goenka Luxitaa, Shenoy Praveen Kumar, Rathnam Krishna Kumar, Seshachalam Arun, Mehra Nikita, Kumar Mummoorthy Ram, Suseela Murugan Mangai, Raghavan Vineetha, Nair Chandran K, Dubashi Biswajit, Dhanushkodi Manikandan, Ganesan Prasanth
Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006 India.
Department of Medical Oncology, Cancer Institute (WIA), Chennai, India.
Indian J Hematol Blood Transfus. 2024 Apr;40(2):237-245. doi: 10.1007/s12288-023-01692-9. Epub 2023 Aug 30.
Early-stage Hodgkin's lymphoma (ESHL) is highly curable, usually with a combination of chemotherapy and radiation. Real-world data may show differences in survival and prognostic factors when compared to clinical trials. There is limited published literature on ESHL from India. The data on the baseline characters, treatment, and outcomes of patients with ESHL (stage IA, IB, and IIA) were obtained from five institutions' medical records and entered in a common database. Event-free survival (EFS) and overall survival (OS) were estimated using the Kaplan Meier method, and cox-regression analysis was used to identify prognostic factors. There were 258 patients [median age was 37 (18-75) years; [males:160 (62%); stage I: 41%; B symptoms: 17 (6%); bulky disease:19 (15%)] treated between 2000 and 2020 who were evaluable. The common chemotherapies used were ABVD [N = 180 (70%)], COPP-ABVD hybrid [N = 52 (21%)], and COPP [N = 14 (5%)]. Median number of cycles were 4 (2-8) and 93 (47%) received radiation at end of treatment. After a median follow-up of 60 months, the 5 years EFS was 87% and OS was 92%. On multivariate analysis, the following factors adversely affected the EFS: Male gender [hazard ratio (HR) = 2.23, = 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20, = 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05, = 0.001], Male gender [hazard ratio (HR) = 3.59, = 0.004], Stage 2 [hazard ratio (HR) = 2.65, = 0.002] and ECOG PS (2-3) [hazard ratio (HR) = 3.35, = 0.01]. Using the hemoglobin, stage and gender a 3-item prognostic score could identify patients with very good outcomes (score 0; 5 years OS:100%) and poor outcomes (score 3; 5 years OS; 49%). This is one of the first multi-center real-world data exclusively focusing on ESHL from India. Though the survival of the entire population was good, there are subsets of patients who have poor outcomes, which may be identified using simple parameters. These parameters need validation in a larger dataset.
The online version contains supplementary material available at 10.1007/s12288-023-01692-9.
早期霍奇金淋巴瘤（ESHL）通常通过化疗和放疗联合治疗，治愈率很高。与临床试验相比，真实世界的数据可能显示出生存率和预后因素的差异。来自印度的关于ESHL的已发表文献有限。从五个机构的医疗记录中获取了ESHL（IA期、IB期和IIA期）患者的基线特征、治疗和结局数据，并录入一个通用数据库。采用Kaplan-Meier方法估计无事件生存期（EFS）和总生存期（OS），并使用Cox回归分析确定预后因素。2000年至2020年间，共有258例可评估患者接受治疗[中位年龄为37（18 - 75）岁；男性：160例（62%）；I期：41%；B症状：17例（6%）；大包块疾病：19例（15%）]。常用的化疗方案为ABVD [N = 180（70%）]、COPP-ABVD联合方案[N = 52（21%）]和COPP [N = 14（5%）]。化疗周期中位数为4（2 - 8）个，93例（47%）患者在治疗结束时接受了放疗。中位随访60个月后，5年EFS为87%，OS为92%。多因素分析显示，以下因素对EFS有不利影响：男性[风险比（HR）= 2.23，P = 0.02]和血红蛋白<10.5g/dL[风险比（HR）= 2.20，P = 0.02]；以下因素对OS有不利影响：血红蛋白<10.5g/dL[风险比（HR）= 4.05，P = 0.001]、男性[风险比（HR）= 3.59，P = 0.004]、II期[风险比（HR）= 2.65，P = 0.002]和东部肿瘤协作组体能状态（ECOG PS）为2 - 3级[风险比（HR）= 3.35，P = 0.01]。利用血红蛋白、分期和性别构建的一个三项预后评分可以识别出预后非常好的患者（评分0；5年OS：100%）和预后差的患者（评分3；5年OS：49%）。这是首批专门关注印度ESHL的多中心真实世界数据之一。尽管总体人群的生存率良好，但仍有部分患者预后较差，可通过简单参数识别。这些参数需要在更大的数据集中进行验证。
在线版本包含可在10.1007/s12288-023-
