沙特阿拉伯新诊断的经典型霍奇金淋巴瘤患者的临床特征与结局:一项多中心队列研究

Clinical features and outcomes of newly diagnosed classical Hodgkin lymphoma patients in Saudi Arabia: a multicenter cohort study.

作者信息

Alalawi Mai, Alrajhi Abdullah M, Alshahrani Walaa A, Alotaibi Amal H, Alhaj Issa Arwa, Abumostafa Areej, Alhaj Issa Zahra, Alshehri Bashayer, Alyousif Ghadah, Alkhudair Nora, Alsuhebany Nada, Alzahrani Mohammed, Alghamdi Abrar, Alrashidi Hessah, Alenazi Batoul A, Alonazi Shaden H, Alghamdi Abeer A, Vishwakarma Ramesh, Asiri Mohammed S, Alenazi Abeer A, Alotaibi Moureq, Aldebasi Tariq, Al Sulaiman Khalid

机构信息

Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia.

Clinical Pharmacy Department, King Fahad Medical City, Riyadh, Saudi Arabia.

出版信息

Sci Rep. 2025 May 26;15(1):18308. doi: 10.1038/s41598-025-02577-9.

Abstract

Classical Hodgkin Lymphoma (cHL) is a prominent B-cell neoplasm, that impacts global and Saudi populations. Given limited large-scale studies focusing on HL in Saudi Arabia, this retrospective multicenter cohort study reviewed the characteristics and clinical outcomes of patients with cHL in Saudi Arabia. All adult patients aged 18 years and older newly diagnosed with cHL at three local tertiary care hospitals were included between January 2016 and December 2021. The primary outcome was to identify the patient's clinical features such as histopathology, risk category, disease stage, and favorable and unfavorable risk factors. Other outcomes include the complete response (CR) assessment post the initial chemotherapy, complications post-chemotherapy, time from cHL initial diagnosis to either refractoriness or relapse disease, progression-free survival (PFS), and overall survival (OS) rate, which were considered secondary. Out of 765 screened patients, 498 patients with cHL were included. The cohort had a median age of 30 years. Histopathological analysis revealed that the majority of the patients had nodular sclerosis (80.7%) and were classified as stage IV (44.8%). The predominant chemotherapy regimen administered was ABVD, utilized in 84.9%. The overall response rate was 90.4%, with 85.2% achieving complete remission. After a median follow-up duration of 3.5 years, the OS was 94.9%, and the PFS was 82.1%. Among patients with relapsed or refractory disease, 56 underwent hematopoietic stem cell transplantation as a part of second-line therapy. The overall response rate post-second-line was 80%. Notably, patients who underwent transplantation had a significantly longer median OS compared to those who did not (49.3 vs. 42.8 months; p = 0.04). However, no significant difference in PFS was observed (9.8 vs. 9.4 months; p = 0.32). This national study offers insights into the clinical features and outcomes of cHL patients in Saudi Arabia, demonstrating that ABVD chemotherapy achieves a high overall response rate and complete remission, with favorable survival rates after a median follow-up of 3.5 years. Furthermore, hematopoietic stem cell transplantation improves median overall survival for patients with relapsed or refractory disease, underscoring the need for close monitoring to manage side effects and enhance outcomes.

摘要

经典型霍奇金淋巴瘤(cHL)是一种显著的B细胞肿瘤,对全球和沙特人群均有影响。鉴于沙特阿拉伯针对HL的大规模研究有限,这项回顾性多中心队列研究回顾了沙特阿拉伯cHL患者的特征和临床结局。纳入了2016年1月至2021年12月期间在当地三家三级医疗中心新诊断为cHL的所有18岁及以上成年患者。主要结局是确定患者的临床特征,如组织病理学、风险类别、疾病分期以及有利和不利风险因素。其他结局包括初始化疗后的完全缓解(CR)评估、化疗后并发症、从cHL初始诊断到难治或复发疾病的时间、无进展生存期(PFS)和总生存期(OS)率,这些被视为次要结局。在765例筛查患者中,纳入了498例cHL患者。该队列的中位年龄为30岁。组织病理学分析显示,大多数患者为结节硬化型(80.7%),并被归类为IV期(44.8%)。主要使用的化疗方案是ABVD,使用率为84.9%。总缓解率为90.4%,其中85.2%实现完全缓解。中位随访3.5年后,OS为94.9%,PFS为82.1%。在复发或难治性疾病患者中,56例接受了造血干细胞移植作为二线治疗的一部分。二线治疗后的总缓解率为80%。值得注意的是,接受移植的患者的中位OS明显长于未接受移植的患者(49.3个月对42.8个月;p = 0.04)。然而,PFS未观察到显著差异(9.8个月对9.4个月;p = 0.32)。这项全国性研究提供了关于沙特阿拉伯cHL患者临床特征和结局的见解,表明ABVD化疗实现了较高的总缓解率和完全缓解率,中位随访3.5年后生存率良好。此外,造血干细胞移植改善了复发或难治性疾病患者的中位总生存期,强调了密切监测以管理副作用和改善结局的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f15f/12106644/a8915a80914a/41598_2025_2577_Fig1_HTML.jpg

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