Prognostic Factors of Hodgkin's Lymphoma and their Impact on Response to Chemotherapy and Survival
Objective : The aim of this study was to compare the standard prognostic factors of Hodgkin's lymphoma (HL) in relation to response to first line chemotherapy, disease free survival (DFS) and overall survival (OS). Patients and Methods : The study was performed on a group of 100 adult patients...
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Veröffentlicht in: | Journal of Egyptian National Cancer Institute 2005-03, Vol.17 (1), p.9-14 |
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Zusammenfassung: | Objective : The aim of this study was to compare the
standard prognostic factors of Hodgkin's lymphoma (HL)
in relation to response to first line chemotherapy, disease
free survival (DFS) and overall survival (OS).
Patients and Methods : The study was performed on
a group of 100 adult patients diagnosed as HL and who
were treated and followed-up in the years 1999 to 2001,
in the Medical Oncology Department at National Cancer
Institute (NCI), Cairo. The first line chemotherapy was
COPP in 40 %, ABVD in 35 % and COPP/ABV hybrid in
25 %. Patients were classified into early stage disease:
Stages I, IIA and IIB without poor risk factors, n = 43 and
advanced stage disease : Stages III, IV and IIB with poor
risk factors, n = 57 analysis of the prognostic factors for
early versus advanced-stage disease was done by univariate
and multivariate regression analysis.
Results : Complete remission (CR) was attained in
69 % of the patients after first line chemotherapy ; being
87.8 % and 54.7 % for early and advanced disease, respectively,
(p = 0.0001). The CR rates after different chemotherapy
regimens were 81.8 %, 90 % and 90 % for the
ABVD, COPP and COPP / ABV hybrid regimens in the
early-disease group ; respectively ; in contrast to the corresponding
figures of 54.5 %, 50 % and 61.5 % in the advanced-
stage group. The DFS at 4 years, was 94 %, 55 %
and 54.5 % for the patients treated with ABVD, COPP and
COPP / ABV hybrid, respectively (p = 0.2). The DFS and
OS in this series of patients were 61.3 % and 53.7 %, being
69.8 % and 70.7 % for the early and 45.1 % and 38.9 % for
the advanced-disease, respectively The OS of the whole
group was significantly related to age (p = 0.04), sex
(p = 0.005), early versus advanced disease (p = 0.0001) and
B symptoms (p = 0.0006).
Conclusions : The adequate response and DFS of the
early compared to the advanced-stage disease supported
the evolving role of risk adapted chemotherapy for HL.
The prognostic factors proved to be of significant impact
in our series. The results of this study pointed to the need
for an improved treatment strategy in this potentially
curable disease, especially for the advanced disease. |
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ISSN: | 1110-0362 1687-9996 |