Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: A population-based analysis Journal Article


Authors: Gerber, N. K.; Atoria, C. L.; Elkin, E. B.; Yahalom, J.
Article Title: Characteristics and outcomes of patients with nodular lymphocyte-predominant Hodgkin lymphoma versus those with classical Hodgkin lymphoma: A population-based analysis
Abstract: Purpose Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is rare, comprising approximately 5% of all Hodgkin lymphoma (HL) cases. Patients with NLPHL tend to have better prognoses than those with classical HL (CHL). Our goal was to assess differences in survival between NLPHL and CHL patients, controlling for differences in patient and disease characteristics. Methods and Materials Using data from the population-based Surveillance, Epidemiology and End Results (SEER) cancer registry program, we identified patients diagnosed with pathologically confirmed HL between 1988 and 2010. Results We identified 1,162 patients with NLPHL and 29,083 patients with CHL. With a median follow-up of 7 years, 5- and 10-year overall survival (OS) rates were 91% and 83% for NLPHL, respectively, and 81% and 74% for CHL, respectively. After adjusting for all available characteristics, NLPHL (vs CHL) was associated with higher OS (hazard ratio [HR]: 0.62, P<.01) and disease-specific survival (DSS; HR: 0.48, P<.01). The male predominance of NLPHL, compared to CHL, as well as the more favorable prognostic features in NLPHL patients are most pronounced in NLPHL patients <20 years old. Among all NLPHL patients, younger patients were less likely to receive radiation, and radiation use has declined by 40% for all patients from 1988 to 2010. Receipt of radiation was associated with better OS (HR: 0.64, P=.03) and DSS (HR: 0.45, P=.01) in NLPHL patients after controlling for available baseline characteristics. Other factors associated with OS and DSS in NLPHL patients are younger age and early stage. Conclusions Our results in a large population dataset demonstrated that NLPHL patients have improved prognosis compared to CHL patients, even after accounting for stage and baseline characteristics. Use of radiation is declining among NLPHL patients despite an association in this series between radiation and better DSS and OS. Unique treatment strategies for NLPHL are warranted in both early and advanced stage disease. © 2015 The Authors.
Keywords: patient monitoring; oncology; diagnosis; hazard ratio; lymphocytes; diseases; overall survival rates; population statistics; methods and materials; cancer registries; disease-specific survivals; large population; population based surveillance; radiation use
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 92
Issue: 1
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2015-05-01
Start Page: 76
End Page: 83
Language: English
DOI: 10.1016/j.ijrobp.2015.02.012
PROVIDER: scopus
PUBMED: 25863756
DOI/URL:
Notes: Export Date: 4 May 2015 -- Source: Scopus
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MSK Authors
  1. Joachim Yahalom
    461 Yahalom
  2. Elena B Elkin
    161 Elkin
  3. Naamit Kurshan Gerber
    19 Gerber
  4. Coral Lynn Atoria
    50 Atoria