Hodgkin’s lymphoma therapy results with a view to the treatment of relapses and primary progression

Overview

Between January 1996 and September 2004, 128 adult patients with Hodgkin’s lymphoma were treated at the Department of Clinical Haematology in Hradec Kralove. The group included 62 males and 66 females with median age 30 years (range, 17–74). Primotherapy of choice was chemotherapy alone (29 %), chemotherapy and radiotherapy (69.5 %) and radiotherapy alone (1.5 %). All patients (n = 128) and group of patients with primary progression and/or relapse (n = 29) were evaluated retrospectively. The median of the follow up was 41 months (range, 4–107). For survival analysis, Kaplan-Meier method was used, significance was tested using the logrank test. 111 patients (87 %) achieved complete remission after primotherapy, 12 patients (11 %) subsequently relapsed. The failure of primotherapy (primary progression) was observed in 17 patients (13 %). 62 % patients with primary progression and relapse were treated with high-dose chemotherapy followed by autologous stem cell transplantation. The probabilities of 4-year overall survival and disease free survival are 92 % and 86 %. The group of patients who achieved complete remission after chemotherapy had significantly longer overall survival (p < 0.001). Longer overall survival was also observed in patients with relapse vs primary progression (p = 0.002). The success of lymphoma therapy depends on accurate staging to determine the patient’s individual prognosis and select direct the most effective and least toxic treatment.

Key words:
Hodgkin’s lymphoma, primary progression, relapse, chemotherapy, radiotherapy, autologous stem cell transplantation