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The impact of autoimmune cytopenias on the clinical course and survival of Hodgkin lymphoma

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Abstract

The characteristics of autoimmune cytopenias (AICP) associated with Hodgkin lymphoma (HL) are not thoroughly defined. We retrospectively assessed the clinical features of HL-associated AICPs in 563 HL patients diagnosed over a period of 28 years. We identified 8 cases of autoimmune hemolytic anemia (AIHA) and 8 cases of autoimmune thrombocytopenia among 14 patients altogether. Four (26%) AICPs were present at lymphoma diagnosis, while 11 (74%) cytopenias occurred during follow-up after first-line therapy. The overall incidence of HL-associated AICPs was 2.8%. Nine (75%) cytopenias responded to intravenous steroids. Seven (46%) AICPs led to the diagnosis of HL, indicated a relapse, or revealed secondary malignancies. AIHAs and AICPs altogether were more likely to develop in patients with advanced-stage HL (p = 0.010 and p < 0.004, respectively). HL patients experiencing AICPs had an increased short-term (1-year) mortality compared to the general HL population (p < 0.022). The 5-year OS of HL patients with concurrent AICPs at diagnosis was inferior compared to HL patients developing AICPs during follow-up (p = 0.005), and to HL patients without AICPs (p < 0.001). Patients with HL-associated AICPs appear to have a particular disease-related profile. The association of HL and AICPs may increase short-term mortality, while patients with concurrent AICPs at HL diagnosis have a dismal prognosis.

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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors received no specific funding for this work.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

    László Imre Pinczés, Roxána Szabó, Zsófia Miltényi & Árpád Illés

  2. Doctoral School of Clinical Medicine, University of Debrecen, Debrecen, Hungary

    László Imre Pinczés, Zsófia Miltényi & Árpád Illés

Authors
  1. László Imre Pinczés
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  2. Roxána Szabó
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  3. Zsófia Miltényi
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  4. Árpád Illés
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by LIP, and RS. The first draft of the manuscript was written by LIP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to László Imre Pinczés.

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The authors declare that they have no conflict of interest.

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This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Regional and Institutional Ethics Committee, Clinical Center, University of Debrecen. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Pinczés, L.I., Szabó, R., Miltényi, Z. et al. The impact of autoimmune cytopenias on the clinical course and survival of Hodgkin lymphoma. Int J Hematol 113, 175–182 (2021). https://doi.org/10.1007/s12185-020-03021-6

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  • DOI: https://doi.org/10.1007/s12185-020-03021-6

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