Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan.
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.
Itoh
Kuniaki
K
Division of Oncology and Hematology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. kaito@east.ncc.go.jp
Kinoshita
Tomohiro
T
Watanabe
Takashi
T
Yoshimura
Kenichi
K
Okamoto
Rumiko
R
Chou
Takaaki
T
Ogura
Michinori
M
Hirano
Masami
M
Asaoku
Hideki
H
Kurosawa
Mitsutoshi
M
Maeda
Yoshiharu
Y
Omachi
Ken
K
Moriuchi
Yukiyoshi
Y
Kasai
Masaharu
M
Ohnishi
Kazunori
K
Takayama
Nobuyuki
N
Morishima
Yasuo
Y
Tobinai
Kensei
K
Kaba
Harumi
H
Yamamoto
Seiichiro
S
Fukuda
Haruhiko
H
Kikuchi
Masahiro
M
Yoshino
Tadashi
T
Matsuno
Yoshihiro
Y
Hotta
Tomomitsu
T
Shimoyama
Masanori
M
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
D000970:Antineoplastic Agents