Hodgkin lymphoma arising in patients with chronic lymphocytic leukemia: Outcomes from a large multi-center collaboration Journal Article


Authors: Stephens, D. M.; Boucher, K.; Kander, E.; Parikh, S. A.; Parry, E. M.; Shadman, M.; Pagel, J. M.; Cooperrider, J.; Rhodes, J.; Mato, A.; Winter, A.; Hill, B.; Gaballa, S.; Danilov, A.; Phillips, T.; Brander, D. M.; Smith, S. M.; Davids, M.; Rogers, K.; Glenn, M. J.; Byrd, J. C.
Article Title: Hodgkin lymphoma arising in patients with chronic lymphocytic leukemia: Outcomes from a large multi-center collaboration
Abstract: Chronic lymphocytic leukemia (CLL) patients who develop Hodgkin lymphoma (HL) have limited survival. No current therapeutic standard of care exists. We conducted a multi-center retrospective study of patients with Hodgkin Transformation (HT) of CLL. Clinicobiologic characteristics, treatment type, and survival outcomes were analyzed and compared with historic case series. Ninety-four patients were identified. Median age at HT was 67 years (range, 38-85). Median time from CLL diagnosis to HT was 5.5 years (range, 0-20.2). Prior to HT, patients received a median of 2 therapies for CLL (range, 0-12). As initial therapy for HT, 61% (n=62) received ABVD-based regimens (adriamycin, bleomycin, vinblastine, and dacarbazine). Seven (7%) patients received hematopoietic cell transplantation (HCT) while in first complete remission (CR1). The median number of treatments for HT per patient was 1 (range, 0-5) with 59 (61%) patients only receiving one line of therapy. After HT, patients had a median follow-up of 1.6 years (range, 0-15.1). Two-year overall survival (OS) after HT diagnosis was 72% (95%CI 62-83%). The patients who received standard ABVD-based therapy had a median OS of 13.2 years. Although limited by small sample size, the patients who underwent HCT for HT in CR1 had a similar 2-year OS (n=7; 67%) compared to patients who did not undergo HCT for HT in CR1 (n=87; 72%; p=0.46). In this multi-center study, HT patients treated with ABVD-based regimens had prolonged survival supporting the use of these regimens as standard of care for these patients.
Keywords: survival; fludarabine; vincristine; daunorubicin; transformation; prognostic-factors; gm-csf; liposomal; ibrutinib; fractionated cyclophosphamide; richters-syndrome
Journal Title: Haematologica
Volume: 106
Issue: 11
ISSN: 0390-6078
Publisher: Ferrata Storti Foundation  
Date Published: 2021-11-01
Start Page: 2845
End Page: 2852
Language: English
DOI: 10.3324/haematol.2020.256388
PUBMED: 33054118
PROVIDER: scopus
PMCID: PMC8561295
DOI/URL:
Notes: Article -- Export Date: 2 November 2020 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Anthony R Mato
    235 Mato