Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India
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...
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| Veröffentlicht in: | Indian journal of hematology & blood transfusion 2024-04, Vol.40 (2), p.237-245 |
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| creator | 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 |
| description | 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,
P
= 0.02] and Hemoglobin |
| doi_str_mv | 10.1007/s12288-023-01692-9 |
| format | Article |
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P
= 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20,
P
= 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05,
P
= 0.001], Male gender [hazard ratio (HR) = 3.59,
P
= 0.004], Stage 2 [hazard ratio (HR) = 2.65,
P
= 0.002] and ECOG PS (2–3) [hazard ratio (HR) = 3.35,
P
= 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.</description><identifier>ISSN: 0971-4502</identifier><identifier>ISSN: 0974-0449</identifier><identifier>EISSN: 0974-0449</identifier><identifier>EISSN: 0971-4502</identifier><identifier>DOI: 10.1007/s12288-023-01692-9</identifier><identifier>PMID: 38708161</identifier><language>eng</language><publisher>New Delhi: Springer India</publisher><subject>Blood Transfusion Medicine ; Chemotherapy ; Gender ; Hematology ; Hemoglobin ; Human Genetics ; Lymphoma ; Medical prognosis ; Medicine ; Medicine & Public Health ; Oncology ; Original Article ; Radiation</subject><ispartof>Indian journal of hematology & blood transfusion, 2024-04, Vol.40 (2), p.237-245</ispartof><rights>The Author(s), under exclusive licence to Indian Society of Hematology and Blood Transfusion 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-daa6041b1d5e379813a824e9b6a37d2840a9a91ae0068dbc6259ae13712b7dc83</cites><orcidid>0000-0003-2762-6591</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12288-023-01692-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12288-023-01692-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38708161$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Singuluri, Lakshmi Sandhya</creatorcontrib><creatorcontrib>Jayachandran, Perumal Kalaiyarasi</creatorcontrib><creatorcontrib>Goenka, Luxitaa</creatorcontrib><creatorcontrib>Shenoy, Praveen Kumar</creatorcontrib><creatorcontrib>Rathnam, Krishna Kumar</creatorcontrib><creatorcontrib>Seshachalam, Arun</creatorcontrib><creatorcontrib>Mehra, Nikita</creatorcontrib><creatorcontrib>Kumar, Mummoorthy Ram</creatorcontrib><creatorcontrib>Suseela, Murugan Mangai</creatorcontrib><creatorcontrib>Raghavan, Vineetha</creatorcontrib><creatorcontrib>Nair, Chandran K.</creatorcontrib><creatorcontrib>Dubashi, Biswajit</creatorcontrib><creatorcontrib>Dhanushkodi, Manikandan</creatorcontrib><creatorcontrib>Ganesan, Prasanth</creatorcontrib><title>Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India</title><title>Indian journal of hematology & blood transfusion</title><addtitle>Indian J Hematol Blood Transfus</addtitle><addtitle>Indian J Hematol Blood Transfus</addtitle><description>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,
P
= 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20,
P
= 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05,
P
= 0.001], Male gender [hazard ratio (HR) = 3.59,
P
= 0.004], Stage 2 [hazard ratio (HR) = 2.65,
P
= 0.002] and ECOG PS (2–3) [hazard ratio (HR) = 3.35,
P
= 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.</description><subject>Blood Transfusion Medicine</subject><subject>Chemotherapy</subject><subject>Gender</subject><subject>Hematology</subject><subject>Hemoglobin</subject><subject>Human Genetics</subject><subject>Lymphoma</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Radiation</subject><issn>0971-4502</issn><issn>0974-0449</issn><issn>0974-0449</issn><issn>0971-4502</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kctuEzEUhi0EotcXYIEssWFj8G1m7O6q0tBIQUVqu7bOjJ102hk72J5FdrwGr9cnwUkKSF2wsiV_57PO_yP0jtFPjNLmc2KcK0UoF4SyWnOiX6FDqhtJqJT69e7OiKwoP0BHKT1QWjMhq7foQKiGKlazQ-S_x7DyIeW-wzPocogJg7f4espdGF3CYYkvIQ4bcpNh5fBVsKvH3j_9_JXwYjOu78MIZ_jbNOSezH3R5Cn3wcOAv0AGPIthxDdhyvd47m0PJ-jNEobkTp_PY3Q3u7y9uCKL66_zi_MF6QSvM7EANZWsZbZyotGKCVBcOt3WIBrLlaSgQTNwZSVl267mlQbHRMN429hOiWP0ce9dx_BjcimbsU-dGwbwLkzJCFoxyaWqdEE_vEAfwhTLBjuqhFsy2wr5nupiSCm6pVnHfoS4MYyabRtm34YpA2bXhtmq3z-rp3Z09u_In_gLIPZAKk9-5eK_v_-j_Q1Y6ZVx</recordid><startdate>20240401</startdate><enddate>20240401</enddate><creator>Singuluri, Lakshmi Sandhya</creator><creator>Jayachandran, Perumal Kalaiyarasi</creator><creator>Goenka, Luxitaa</creator><creator>Shenoy, Praveen Kumar</creator><creator>Rathnam, Krishna Kumar</creator><creator>Seshachalam, Arun</creator><creator>Mehra, Nikita</creator><creator>Kumar, Mummoorthy Ram</creator><creator>Suseela, Murugan Mangai</creator><creator>Raghavan, Vineetha</creator><creator>Nair, Chandran K.</creator><creator>Dubashi, Biswajit</creator><creator>Dhanushkodi, Manikandan</creator><creator>Ganesan, Prasanth</creator><general>Springer India</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2762-6591</orcidid></search><sort><creationdate>20240401</creationdate><title>Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India</title><author>Singuluri, Lakshmi Sandhya ; 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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,
P
= 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20,
P
= 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05,
P
= 0.001], Male gender [hazard ratio (HR) = 3.59,
P
= 0.004], Stage 2 [hazard ratio (HR) = 2.65,
P
= 0.002] and ECOG PS (2–3) [hazard ratio (HR) = 3.35,
P
= 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.</abstract><cop>New Delhi</cop><pub>Springer India</pub><pmid>38708161</pmid><doi>10.1007/s12288-023-01692-9</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-2762-6591</orcidid></addata></record> |
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| source | Springer Nature - Complete Springer Journals |
| subjects | Blood Transfusion Medicine Chemotherapy Gender Hematology Hemoglobin Human Genetics Lymphoma Medical prognosis Medicine Medicine & Public Health Oncology Original Article Radiation |
| title | Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India |
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