title: Lymphocyte-predominant and classical Hodgkin's lymphoma--comparison of outcomes.
abstract: BACKGROUND
  Lymphocyte predominant Hodgkin's lymphoma (LPHL) differs in histological and clinical presentation from classical Hodgkin's lymphoma (cHL). Treatment of LPHL patients using standard Hodgkin's lymphoma (HL) protocols leads to complete remission (CR) in more than 95% of patients. However, differences in terms of relapse rates, survival and freedom from treatment failure (FFTF) between LPHL and cHL patients were suggested by a recent intergroup analysis. To obtain a more comprehensive picture, we reviewed all LPHL-cases registered in the GHSG database and compared patient characteristics and treatment outcome with cHL patients.
  
  
  METHODS
  We retrospectively analyzed 8298 HL patients treated within the GHSG trials (HD4-HD12): 394 LPHL patients and 7904 cHL patients. From 394 LPHL patients 63% were in early stage, 16% in intermediate and 21% in advanced stage of disease. Of the 7904 cHL patients analyzed, 22% were in early, 39% in intermediate and 39% in advanced stages. About 9% of LPHL patients had B symptoms compared to 40% in cHL patients.
  
  
  RESULTS
  About 91% LPHL vs. 86% cHL patients in early stages, 86% vs. 83% in intermediate and 79% vs. 75% in advanced stages reached CR/CRu. Additional analysis for LPHL IA patients showed 98% CR/CRu after extended field, 100% after involved field (IF) and 98% CR/CRu after combined modality treatment. About 0.3% LPHL patients developed progressive disease (PD) compared to 3.7% cHL patients. The relapse rate of LPHL patients was very similar to cHL (8.1% vs. 7.9%). There were 2.5% secondary malignancies in LPHL and 3.7% in cHL patients. About 4.3% LPHL patients and 8.8% cHL patients died. The FFTF rates for LPHL and cHL patients at a median observation of 41 or 48 months were 92% and 84%, respectively. The OS for LPHL and cHL patients was 96% and 92%, respectively.
  
  
  CONCLUSIONS
  The cHL patients present more frequently with advanced stages and B symptoms compared to LPHL patients. There was no difference in treatment outcome in terms of CR/CRu, PD and mortality between LPHL and HL. Surprisingly, there were also no differences in patients with relapse.
authors: Clinic I for Internal Medicine, University Hospital Cologne, Cologne, Germany. lucia.nogova@uk-koeln.de
authors: Lucia
authors: L
authors: Nogová
authors: Thorsten
authors: T
authors: Reineke
authors: Andreas
authors: A
authors: Josting
authors: Hans K
authors: HK
authors: Müller-Hermelink
authors: Hans T
authors: HT
authors: Eich
authors: Karolin
authors: K
authors: Behringer
authors: Rolf-Peter
authors: RP
authors: Müller
authors: Volker
authors: V
authors: Diehl
authors: Andreas
authors: A
authors: Engert
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D018572:Disease-Free Survival; D006689:Hodgkin Disease / Q000145:classification / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D012189:Retrospective Studies; D016896:Treatment Outcome