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. 2023 Apr 4;7(4):e837.
doi: 10.1097/HS9.0000000000000837. eCollection 2023 Apr.

Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi

Manuel Gotti  1 , Roberta Sciarra  1   2 , Alessandro Pulsoni  3 , Francesco Merli  4 , Stefano Luminari  4   5 , Caterina Zerbi  2 , Livio Trentin  6 , Alessandro Re  7 , Chiara Rusconi  8 , Simonetta Viviani  8 , Andrea Rossi  9 , Federica Cocito  10 , Barbara Botto  11 , Erika Meli  12 , Antonello Pinto  13 , Irene Dogliotti  14 , Guido Gini  15 , Benedetta Puccini  16 , Francesca Ricci  17 , Luca Nassi  18 , Alberto Fabbri  19 , Anna Marina Liberati  20 , Michele Merli  21 , Andrea Riccardo Filippi  22   23 , Maurizio Bonfichi  1 , Valentina Zoboli  1 , Germana Tartaglia  3 , Giorgia Annechini  3 , Gianna Maria D'Elia  3 , Ilaria Del Giudice  3 , Isabel Alvarez  4 , Andrea Visentin  6 , Stefano Pravato  6 , Daniela Dalceggio  7 , Chiara Pagani  7 , Silvia Ferrari  9 , Caterina Cristinelli  2 , Tanja Lazic  2 , Virginia Valeria Ferretti  24 , Umberto Ricardi  25 , Luca Arcaini  1   2
Affiliations

Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi

Manuel Gotti et al. Hemasphere. .

Abstract

Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5-12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II-III-IV NLPHL.

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Conflict of interest statement

LA received advisory honoraria from Roche, Celgene, Janssen-Cilag, Verastem, Eusa Pharma, and Incyte, research support from Gilead, and travel expenses from Roche, Celgene, Janssen-Cilag, and Eusa Pharma, speakers bureau from Novartis. AP declares honoraria from Roche. All the other authors have no conflicts of interest to disclose.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
Survival outcome. OS (A) and PFS (B) of 294 patients with nodular lymphocyte-predominant Hodgkin lymphoma according to stage. CI = confidence interval; OS = overall survival; PFS = progression-free survival.
Figure 2.
Figure 2.
Survival outcome. OS (A) and PFS (B) of 193 chemotreated patients with stage II, III, IV nodular lymphocyte-predominant Hodgkin lymphoma according to the use of rituximab. CI = confidence interval; OS = overall survival; PFS = progression-free survival.
See this image and copyright information in PMC

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