title: Long-Term Course of Patients With Stage IA Nodular Lymphocyte-Predominant Hodgkin Lymphoma: A Report From the German Hodgkin Study Group.
abstract: OBJECTIVE
  The optimal treatment of stage IA nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is not well defined. Thus, we performed an analysis using the database of the German Hodgkin Study Group.
  
  
  METHODS
  The long-term outcome of 256 patients with stage IA NLPHL was evaluated. Patients had received combined-modality treatment (CMT; n = 72), extended-field radiotherapy (EF-RT; n = 49), involved-field radiotherapy (IF-RT; n = 108), or four weekly standard doses of rituximab (n = 27) within German Hodgkin Study Group clinical trial protocols between 1988 and 2009.
  
  
  RESULTS
  The median age at NLPHL diagnosis was 39 years (range, 16 to 75 years). Most patients were male (76%). The whole patient group had a median follow-up of 91 months (CMT: 95 months; EF-RT: 110 months; IF-RT: 87 months; rituximab: 49 months). At 8 years, progression-free survival and overall survival rates were 88.5% and 98.6% for CMT, 84.3% and 95.7% for EF-RT, and 91.9% and 99.0% for IF-RT, respectively. Patients treated with rituximab had 4-year progression-free and overall survival rates of 81.0% and 100%, respectively. A second malignancy during the course of follow-up was diagnosed in 17 (6.6%) of 256 patients. A total of 12 deaths occurred. However, only one patient died from NLPHL.
  
  
  CONCLUSIONS
  Tumor control in this analysis was equivalent with CMT, EF-RT, and IF-RT. Therefore, IF-RT, which is associated with the lowest risk for the development of toxic effects, should be considered as standard of care for patients with stage IA NLPHL. Rituximab alone is associated with an increased risk of relapse in this patient population.
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Eichenauer
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Plütschow
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: von Tresckow
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Boris
authors.initials: B
authors.lastname: Böll
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Karolin
authors.initials: K
authors.lastname: Behringer
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Hans Theodor
authors.initials: HT
authors.lastname: Eich
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Borchmann
authors.affiliation: All authors: University Hospital Cologne, Cologne; and Hans Theodor Eich, University Hospital Münster, Münster, Germany. a.engert@uni-koeln.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000473:pathology; D012008:Recurrence