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Young adults diagnosed with Hodgkin lymphoma are at risk of relapsing late: a comprehensive analysis of late relapse in Hodgkin lymphoma.
J Cancer Res Clin Oncol. 2018 May;144(5):935-943
Authors: Pinczés L, Miltényi Z, Illés Á
Abstract
PURPOSE: Majority of relapses in Hodgkin lymphoma (HL) occur within 3 years after initial treatment, late relapses (LR), happening 5 or more years after first diagnosis is rare events. Neither clinical characteristics, risk factors, nor optimal treatment is well described for LR patients. Our aim was to provide a comprehensive analysis on the LR of HL to outline a patient population at risk of relapsing late.
PATIENTS AND METHODS: 637 HL patients were treated at the University of Debrecen between 1981 and 2010. Patient data was evaluated retrospectively. Survival analysis was performed using the Kaplan-Meier method and odds ratios (OR) were identified by binary logistic regression models.
RESULTS: With a median observational time of 9.08 years 584 (91%) HL patients achieved complete remission (CR) after first line treatment. Relapse occurred in 176 (28%) patients, 26 (4%) of them 5 or more years after first diagnosis. With multivariable analysis, initial diagnosis before the age of 24 (p < 0.001), initial presentation between 1981 and 1990 or 1991-2000 (p = 0.025 and p = 0.023, respectively) and first line treatment with radiotherapy only (p = 0.034) were identified as independent risk factors for LR. We observed a significantly impaired OS for patients with early relapse HL compared to those in long-term remission or experiencing LR (p < 0.001).
CONCLUSION: Late relapse of HL presents with clinical characteristics very similar to primary disease and appears to have a good prognosis. First diagnosis in childhood or young adulthood and first line treatment before the ABVD era increases the risk of relapsing late.
PMID: 29468437 [PubMed - indexed for MEDLINE]
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