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. 2018 May;144(5):935-943.
doi: 10.1007/s00432-018-2613-9. Epub 2018 Feb 21.

Young adults diagnosed with Hodgkin lymphoma are at risk of relapsing late: a comprehensive analysis of late relapse in Hodgkin lymphoma

László Pinczés  1 , Zsófia Miltényi  2 , Árpád Illés  2
Affiliations

Young adults diagnosed with Hodgkin lymphoma are at risk of relapsing late: a comprehensive analysis of late relapse in Hodgkin lymphoma

László Pinczés et al. J Cancer Res Clin Oncol. 2018 May.

Abstract

Purpose: Majority of relapses in Hodgkin lymphoma (HL) occur within 3 years after initial treatment, late relapses (LR), happening 5 or more years after first diagnosis is rare events. Neither clinical characteristics, risk factors, nor optimal treatment is well described for LR patients. Our aim was to provide a comprehensive analysis on the LR of HL to outline a patient population at risk of relapsing late.

Patients and methods: 637 HL patients were treated at the University of Debrecen between 1981 and 2010. Patient data was evaluated retrospectively. Survival analysis was performed using the Kaplan-Meier method and odds ratios (OR) were identified by binary logistic regression models.

Results: With a median observational time of 9.08 years 584 (91%) HL patients achieved complete remission (CR) after first line treatment. Relapse occurred in 176 (28%) patients, 26 (4%) of them 5 or more years after first diagnosis. With multivariable analysis, initial diagnosis before the age of 24 (p < 0.001), initial presentation between 1981 and 1990 or 1991-2000 (p = 0.025 and p = 0.023, respectively) and first line treatment with radiotherapy only (p = 0.034) were identified as independent risk factors for LR. We observed a significantly impaired OS for patients with early relapse HL compared to those in long-term remission or experiencing LR (p < 0.001).

Conclusion: Late relapse of HL presents with clinical characteristics very similar to primary disease and appears to have a good prognosis. First diagnosis in childhood or young adulthood and first line treatment before the ABVD era increases the risk of relapsing late.

Keywords: ABVD; Early relapse; Hodgkin lymphoma; Late relapse; Overall survival; Risk factors.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Subgroup analysis of overall survival (OS) in late relapse (LR) patients. a First diagnosis at the age of < 24 vs. ≥ 24 years. b First diagnosis between 1981 and 1990; 1991–2000 or 2001–2010. c First diagnosis with stage I/II vs. stage III/IV disease. d Presence of B symptoms at first diagnosis. e First line treatment with CT vs. RT vs. CMT. f AHSCT after experiencing LR
See this image and copyright information in PMC

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