Τίτλος:
Prognostic factors in advanced stage Hodgkin's lymphoma: the
significance of the number of involved anatomic sites
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Advanced Hodgkin’s lymphoma (HL) is curable by conventional
chemotherapy in 60-70% of patients. The pretreatment identification of
a sizeable subgroup of patients with sufficiently low failure-free
survival (FFS) to be eligible for investigational treatment is
necessary. Objectives: To determine the prognostic significance of the
number of involved sites (NIS) in patients with advanced HL and its
relationship to the International Prognostic Score (IPS). Methods: A
retrospective review of patients with advanced HL, defined as Ann Arbor
stage (AAS) IB, IIB, III or IV, treated with anthracycline-based
regimens. The end-point was FFS. Results: We identified 277 patients
with a median age of 32 yr (14-78), 57% of whom were males. AAS was I
in 4% of patients, It in 29%, III in 38% and IV in 29%. B-symptoms
were recorded in 81%. Most patients had nodular sclerosis (64%) and
mixed cellularity (26%) histology. IPS was greater than or equal to3 in
44% of 242 evaluable patients. The NIS was greater than or equal to 5
in 32% of the patients and 20% of all patients had both greater than
or equal to 5 involved sites and IPS greater than or equal to 3. The
10-yr FFS was 67%, being 76% vs. 50% for patients with less than or
equal to4 vs. greater than or equal to5 involved sites (P<0.0001). The
NIS (greater than or equal to5), AAS IV and anemia were independent
predictors of FFS in multivariate analysis. The NIS remained significant
along with IPS, when the latter was included in the analysis. Patients
with greater than or equal to5 involved sites and IPS greater than or
equal to 3 had 10-yr FFS overall, and relapse-free survival of 41% 45%
and 49%, respectively. Conclusions: The NIS was associated with FFS in
advanced HL, was independent of IPS, and led to the identification of a
sizeable subgroup of patients with 10-yr FFS of approximately 40%. This
factor should be evaluated during the development of prognostic systems.
Συγγραφείς:
Vassilakopoulos, TP
Angelopoulou, MK
Siakantaris, MP and
Kontopidou, FN
Dimopoulou, MN
Barbounis, A
Grigorakis, V and
Karkantaris, C
Anargyrou, K
Chatziioannou, M
Rombos, J and
Boussiotis, VA
Vaiopoulos, G
Kittas, C
Pangalis, GA
Περιοδικό:
European Journal of Haematology
Λέξεις-κλειδιά:
Hodgkin’s lymphoma; prognostic factors; advance stage; number of
involved sites; International Prognostic Score
DOI:
10.1034/j.1600-0609.2001.00561.x
