Lymphocyte-predominant Hodgkin lymphoma--clinical features and treatment outcomes from a 30-year experience

Ann Oncol. 2010 Oct;21(10):2061-2068. doi: 10.1093/annonc/mdq063. Epub 2010 Mar 23.

Abstract

Background: Lymphocyte-predominant Hodgkin disease (LPHD) is a rare subtype of Hodgkin lymphoma, for which there is limited evidence regarding the presentation, natural history and treatment outcomes.

Patients and methods: We conducted a single-institution retrospective review all of patients diagnosed with LPHD over a 30-year period.

Results: Eighty-eight patients were included. Median follow-up was 13 years. Local radiotherapy or chemoradiotherapy resulted in durable disease control in patients with stage I or II disease. Advanced stage at presentation, presence of B symptoms, low albumin, and either partial response or stable disease to first treatment were associated with worse treatment outcomes. Relapse rate for the entire cohort was 44%, with an 8% rate of transformation to large-cell lymphoma. Rituximab in combination with chemotherapy resulted in durable remission in a heavily pretreated subgroup. Outcomes with autologous transplant are discussed.

Conclusion: Our series has the longest follow-up of any report, includes the only series of patients treated with autologous transplant, and has the largest group of patients treated with rituximab and chemotherapy in this indication.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Combined Modality Therapy
  • Female
  • Hodgkin Disease / pathology
  • Hodgkin Disease / therapy*
  • Humans
  • Lymphocytes / drug effects
  • Lymphocytes / pathology*
  • Lymphocytes / radiation effects
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy Dosage
  • Remission Induction
  • Retrospective Studies
  • Stem Cell Transplantation*
  • Survival Rate
  • Treatment Outcome
  • Young Adult