title: Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan.
abstract: The Japan Clinical Oncology Group conducted two multicenter phase II trials in 200 patients with advanced Hodgkin lymphoma (HL) in the 1990s. Among 181 patients whose histopathological specimens were available and reviewed by 6 hematopathologists, 167 (92.3%) were diagnosed with HL. Five-year overall survival (OS) among these 167 patients was 88.3%, including 89.2% among nodular sclerosis and 82.2% among mixed cellularity cases. International prognostic score was not closely associated with OS. Seven unfavorable prognostic factors for OS on univariate analysis were male, B symptoms, clinical stage of III or IV, elevated serum LDH, elevated alkaline phosphatase, elevated beta2-microglobulin, and pathological subtype (mixed cellularity and lymphocyte depletion). On multivariate analysis, male [HR 3.30 (95% CI 1.15-9.52, p = 0.027)] and elevated serum LDH [HR 2.41 (95% CI 1.07-5.43, p = 0.034)] were independent factors for OS. Based on these prognostic factors, the 5-year OS was 95.7% in the low-risk group (no adverse factor), 87.9% in the intermediate-risk group (1 adverse factor) and 73.3% in the high-risk group (2 adverse factors). This simple prognostic model for HL warrants further validation studies.
authors.affiliation: Division of Oncology and Hematology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. kaito@east.ncc.go.jp
authors.forename: Kuniaki
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authors.lastname: Itoh
authors.forename: Tomohiro
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authors.lastname: Kinoshita
authors.forename: Takashi
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authors.lastname: Watanabe
authors.forename: Kenichi
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authors.lastname: Yoshimura
authors.forename: Rumiko
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authors.forename: Takaaki
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authors.lastname: Asaoku
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authors.forename: Yoshiharu
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authors.lastname: Maeda
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authors.lastname: Omachi
authors.forename: Yukiyoshi
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authors.lastname: Moriuchi
authors.forename: Masaharu
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authors.lastname: Kasai
authors.forename: Kazunori
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authors.lastname: Ohnishi
authors.forename: Nobuyuki
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authors.lastname: Takayama
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authors.lastname: Morishima
authors.forename: Kensei
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authors.lastname: Tobinai
authors.forename: Harumi
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authors.lastname: Kaba
authors.forename: Seiichiro
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authors.lastname: Yamamoto
authors.forename: Haruhiko
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authors.lastname: Fukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuchi
authors.forename: Tadashi
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authors.lastname: Yoshino
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Matsuno
authors.forename: Tomomitsu
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authors.lastname: Hotta
authors.forename: Masanori
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authors.lastname: Shimoyama
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality* / Q000532:radiotherapy; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D017728:Lymphoma, Large-Cell, Anaplastic / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D016399:Lymphoma, T-Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011379:Prognosis; D011878:Radiotherapy / Q000706:statistics & numerical data; D012074:Remission Induction; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents