TY - JOUR
T1 - Interim PET-guided treatment for early-stage NLPHL
T2 - a subgroup analysis of the randomized GHSG HD16 and HD17 studies
AU - Eichenauer, Dennis A.
AU - Bühnen, Ina
AU - Baues, Christian
AU - Kobe, Carsten
AU - Kaul, Helen
AU - Greil, Richard
AU - Moccia, Alden
AU - Zijlstra, Joseé M.
AU - Hertenstein, Bernd
AU - Topp, Max S.
AU - Just, Marianne
AU - von Tresckow, Bastian
AU - Eich, Hans-Theodor
AU - Fuchs, Michael
AU - Dietlein, Markus
AU - Hartmann, Sylvia
AU - Engert, Andreas
AU - Borchmann, Peter
N1 - Funding Information: S.H. is supported by the Deutsche Forschungsgemeinschaft HA6145/7-1 . Publisher Copyright: © 2023 The American Society of Hematology
PY - 2023/8/10
Y1 - 2023/8/10
N2 - The optimal first-line treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) diagnosed in early stages is largely undefined. We, therefore, analyzed 100 NLPHL patients treated in the randomized HD16 (early-stage favorable; n = 85) and HD17 (early-stage unfavorable; n = 15) studies. These studies investigated the omission of consolidation radiotherapy (RT) in patients with a negative interim positron emission tomography (iPET) (ie, Deauville score <3) after chemotherapy (HD16: 2× doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]; HD17: 2× escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [BEACOPP] plus 2× ABVD). Patients with NLPHL treated in the HD16 and HD17 studies had 5-year progression-free survival (PFS) rates of 90.3% and 92.9%, respectively. Thus, the 5-year PFS did not differ significantly from that of patients with classical Hodgkin lymphoma treated within the same studies (HD16: P =.88; HD17: P =.50). Patients with early-stage favorable NLPHL who had a negative iPET after 2× ABVD and did not undergo consolidation RT tended to have a worse 5-year PFS than patients with a negative iPET who received consolidation RT (83% vs 100%; P =.05). There were 10 cases of NLPHL recurrence. However, no NLPHL patient died during follow-up. Hence, the 5-year overall survival rate was 100%. Taken together, contemporary Hodgkin lymphoma-directed treatment approaches result in excellent outcomes for patients with newly diagnosed early-stage NLPHL and, thus, represent valid treatment options. In early-stage favorable NLPHL, consolidation RT appears necessary after 2× ABVD to achieve the optimal disease control irrespective of the iPET result.
AB - The optimal first-line treatment for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) diagnosed in early stages is largely undefined. We, therefore, analyzed 100 NLPHL patients treated in the randomized HD16 (early-stage favorable; n = 85) and HD17 (early-stage unfavorable; n = 15) studies. These studies investigated the omission of consolidation radiotherapy (RT) in patients with a negative interim positron emission tomography (iPET) (ie, Deauville score <3) after chemotherapy (HD16: 2× doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD]; HD17: 2× escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [BEACOPP] plus 2× ABVD). Patients with NLPHL treated in the HD16 and HD17 studies had 5-year progression-free survival (PFS) rates of 90.3% and 92.9%, respectively. Thus, the 5-year PFS did not differ significantly from that of patients with classical Hodgkin lymphoma treated within the same studies (HD16: P =.88; HD17: P =.50). Patients with early-stage favorable NLPHL who had a negative iPET after 2× ABVD and did not undergo consolidation RT tended to have a worse 5-year PFS than patients with a negative iPET who received consolidation RT (83% vs 100%; P =.05). There were 10 cases of NLPHL recurrence. However, no NLPHL patient died during follow-up. Hence, the 5-year overall survival rate was 100%. Taken together, contemporary Hodgkin lymphoma-directed treatment approaches result in excellent outcomes for patients with newly diagnosed early-stage NLPHL and, thus, represent valid treatment options. In early-stage favorable NLPHL, consolidation RT appears necessary after 2× ABVD to achieve the optimal disease control irrespective of the iPET result.
UR - http://www.scopus.com/inward/record.url?scp=85163036477&partnerID=8YFLogxK
U2 - https://doi.org/10.1182/blood.2023019939
DO - https://doi.org/10.1182/blood.2023019939
M3 - Article
C2 - 37257195
SN - 0006-4971
VL - 142
SP - 553
EP - 560
JO - Blood
JF - Blood
IS - 6
ER -