Skip to main content

Advertisement

SpringerLink
Log in

Clinical Profile and Outcome of Adult Classical Hodgkin’s Lymphoma: Real World Single Centre Experience

  • ORIGINAL ARTICLE
  • Published:
Indian Journal of Hematology and Blood Transfusion Aims and scope Submit manuscript

Abstract

Hodgkin’s lymphoma treatment outcomes have been the true success story of modern medicine. Various data from western as well as Indian studies are available for classical Hodgkin’s lymphoma (cHL). Here we report treatment outcomes from a tertiary cancer care centre in Karnataka over a 5 year period. This was a retrospective review of cHL cases aged 15 years and above diagnosed between January 2015 and December 2019 at Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India. The case files of the patients were retrieved and relevant data was collected. Two hundred patients of cHL were included in this study. Median age was 28 years with male to female ratio of 1.56:1. B symptoms were present in 58% cases. Mixed cellularity (46.5%) was the most common histological subtype. Majority patients had advanced stage at presentation (stage III/IV) (62.5%). Extranodal disease was present in 19.5% cases. GHSG early-favourable cases were 15.5%, early-unfavourable cases were 22.0%, while 62.5% were advanced cases. The most common chemotherapy regimen used was ABVD. Eighty-three (41.5%) patients received radiation therapy. Median follow-up was 34.2 months (range 4.1–67.8). The rates for complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) were 84.5%, 8.5%, 5.0% and 2.0% respectively. PFS and OS rate at 6 years were 69.5% and 84.1% respectively. HL is one of the malignancies with high cure rate. The treatment outcome at our centre is comparable to western data and data from other tertiary centres from India.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

cHL:

Classical Hodgkin’s lymphoma

CR:

Complete response

CRu:

Complete response unconfirmed

PR:

Partial response

SD:

Stable disease

PD:

Progressive disease

GHSG:

German Hodgkin’s Study group

IPS:

International Prognostic Score

ESR:

Erythrocyte sedimentation rate

CT:

Computed Tomography

FDG:

Fluorodeoxyglucose

PET–CT:

Positron emission tomography–computed tomography

DLCO:

Diffusing capacity of lung for carbon monoxide

IFRT:

Involved field radiotherapy

PFS:

Progression free survival

OS:

Overall survival

MC:

Mixed cellularity

NS:

Nodular sclerosis

LR:

Lymphocyte rich

LD:

Lymphocyte depleted

ABVD:

Adriamycin, bleomycin, vinblastine, and dacarbazine

AVD:

Adriamycin, vinblastine and dacarbazine

COPP:

Cyclophosphamide, vincristine, prednisone and procarbazine

GVD:

Gemcitabine, vinorelbine and doxorubicin

BEACOPP:

Bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisolone

GDP:

Gemcitabine, dexamethasone and cisplatin

ICE:

Ifosfamide, carboplatin and etoposide

DHAP:

Dexamethasone, cytarabine and cisplatin

EVAP:

Etoposide, vinblastine, doxorubicin and prednisolone

ASCT:

Autologous stem cell transplantation

RTA:

Road traffic accident

AML:

Acute myeloid leukemia

CINV:

Chemotherapy induced nausea and vomiting

GCSF:

Granulocyte colony stimulating factors

References

  1. National Cancer Institute (2018) Surveillance, Epidemiology, and End Results (SEER) Program. Cancer stat facts: Hodgkin lymphoma, 2018. Bethesda, MD: National Cancer Institute

  2. Küppers R (2012) New insights in the biology of Hodgkin lymphoma. Hematol Am Soc Hematol Educ Program 2012:328–334

    Article  Google Scholar 

  3. Swerdlow SH, Campo E, Harris NL et al (eds) (2017) WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edn. IARC Press, Lyon

    Google Scholar 

  4. Diehl V, Thomas RK, Re D (2004) Part II: Hodgkin’s lymphoma–diagnosis and treatment. Lancet Oncol 5(1):19–26

    Article  CAS  PubMed  Google Scholar 

  5. Armitage JO (2010) Early-stage Hodgkin’s lymphoma. N Engl J Med 363(7):653–662

    Article  CAS  PubMed  Google Scholar 

  6. Ansell SM (2018) Hodgkin lymphoma: 2018 update on diagnosis, risk-stratification, and management. Am J Hematol 93(5):704–715

    Article  PubMed  Google Scholar 

  7. Cerci JJ, Pracchia LF, Soares Junior J, LinardiCda C, Meneghetti JC, Buccheri V (2009) Positron emission tomography with 2-[18F]-fluoro-2-deoxy-D-glucose for initial staging of hodgkin lymphoma: a single center experience in Brazil. Clinics (Sao Paulo) 64(6):491–498

    Article  PubMed  Google Scholar 

  8. Ansell SM, Radford J, Connors JM, Długosz-Danecka M, Kim WS, Gallamini A, Ramchandren R, Friedberg JW, Advani R, Hutchings M, Evens AM, Smolewski P, Savage KJ, Bartlett NL, Eom HS, Abramson JS, Dong C, Campana F, Fenton K, Puhlmann M, Straus DJ; ECHELON-1 Study Group (2022) Overall survival with brentuximab vedotin in stage III or IV Hodgkin's lymphoma. N Engl J Med 387(4):310–320

  9. Shenoy P, Maggioncalda A, Malik N, Flowers CR (2011) Incidence patterns and outcomes for Hodgkin lymphoma patients in the United States. Adv Hematol 2011:725219

    Article  PubMed  Google Scholar 

  10. Bessell EM, Bouliotis G, Armstrong S, Baddeley J, Haynes AP, O’Connor S, Nicholls-Elliott H, Bradley M (2012) Long-term survival after treatment for Hodgkin’s disease (1973–2002): improved survival with successive 10-year cohorts. Br J Cancer 107(3):531–536

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Pulte D, Jansen L, Gondos A, Emrich K, Holleczek B, Katalinic A, Brenner H, GEKID Cancer Survival Working Group (2014) Improved population level survival in younger Hodgkin lymphoma patients in Germany in the early 21st century. Br J Haematol 164(6):851–7.

  12. Shanta V, Sastri DV, Sagar TG, Sasikala K, Krishnamurthi S (1982) A review of Hodgkin’s disease at the Cancer Institute. Madras Clin Oncol 8(1):5–15

    CAS  PubMed  Google Scholar 

  13. Dinshaw KA, Advani SH, Gopal R, Nair CN, Talvalkar GV, Gangadharan P, Desai PB (1984) Management of Hodgkin’s disease in western India. Cancer 54(7):1276–1282

    Article  CAS  PubMed  Google Scholar 

  14. Dinshaw K, Pande S, Advani S, Ramakrishnan G, Nair C, Talvalkar G, Rao DN, Notani P, Rao R, Desai P (1985) Pediatric Hodgkin’s disease in India. J Clin Oncol 3(12):1605–1612

    Article  CAS  PubMed  Google Scholar 

  15. Ramadas K, Sankaranarayanan R, Nair MK, Nair B, Padmanabhan TK (1994) Adult Hodgkin’s disease in Kerala. Cancer 73(8):2213–2217

    Article  CAS  PubMed  Google Scholar 

  16. Raina V, Sharma A, Mohanti BK, Kumar R, Dawar R, Rath GK (2003) Etoposide, vinblastine, adriamycin and prednisolone (EVAP) combination chemotherapy as first-line treatment for Hodgkin’s disease. Natl Med J India 16(4):199–203

    PubMed  Google Scholar 

  17. Laskar S, Gupta T, Vimal S, Muckaden MA, Saikia TK, Pai SK, Naresh KN, Dinshaw KA (2004) Consolidation radiation after complete remission in Hodgkin’s disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? J Clin Oncol 22(1):62–68

    Article  CAS  PubMed  Google Scholar 

  18. Arya LS, Dinand V, Thavaraj V, Bakhshi S, Dawar R, Rath GK, Singh R, Vats TS (2006) Hodgkin’s disease in Indian children: outcome with chemotherapy alone. Pediatr Blood Cancer 46(1):26–34

    Article  PubMed  Google Scholar 

  19. Ganesan P, Kumar L, Raina V, Sharma A, Bakhshi S, Sreenivas V, Vijayaraghavan M, Thulkar S (2011) Hodgkin’s lymphoma–long-term outcome: an experience from a tertiary care cancer center in North India. Ann Hematol 90(10):1153–1160

    Article  PubMed  Google Scholar 

  20. Maddi RN, Linga VG, Iyer KK, Chowdary JS, Gundeti S, Digumarti R, Paul TR (2015) Clinical profile and outcome of adult Hodgkin lymphoma: Experience from a tertiary care institution. Indian J Med Paediatr Oncol 36:255–260

    Article  PubMed  PubMed Central  Google Scholar 

  21. Jaffe ES, Harris NL, Stein H, Vardiman JW (eds) (2001) World Health Organization classification of tumors. Pathology and Genetics of Tumors of Hematopoietic and Lymphoid Tissues. IARC Press, Lyon

    Google Scholar 

  22. Hasenclever D, Diehl V (1998) A prognostic score for advanced Hodgkin’s disease. International Prognostic Factors Project on Advanced Hodgkin’s Disease. N Engl J Med 339(21):1506–1514

    Article  CAS  PubMed  Google Scholar 

  23. Cheson BD, Horning SJ, Coiffier B et al (1999) Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 17(4):1244

  24. Mauch PM, Kalish LA, Kadin M, Coleman CN, Osteen R, Hellman S (1993) Patterns of presentation of Hodgkin disease. Implic Etiol Pathog Cancer 71(6):2062–2071

    CAS  Google Scholar 

  25. Vassallo J, Paes RP, Soares FA, Menezes Y, Aldred V, RibeiroKde C, Alves AC (2005) Histological classification of 1025 cases of Hodgkin’s lymphoma from the State of São Paulo, Brazil. Sao Paulo Med J 123(3):134–136

    Article  PubMed  Google Scholar 

  26. Cheong JW, Park SY, Roh JK, Suh CO, Hahn JS (2006) Treatment of Hodgkin’s disease: a twenty-year follow-up of patients at a center in Korea. Yonsei Med J 47(4):455–465

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dinand V, Dawar R, Arya LS, Unni R, Mohanty B, Singh R (2007) Hodgkin’s lymphoma in Indian children: prevalence and significance of Epstein-Barr virus detection in Hodgkin’s and Reed-Sternberg cells. Eur J Cancer 43(1):161–168

    Article  PubMed  Google Scholar 

  28. Karnik S, Srinivasan B, Nair S (2003) Hodgkin’s lymphoma: immunohistochemical features and its association with EBV LMP-1. Experience from a South Indian hospital. Pathology 35(3):207–211

    Article  Google Scholar 

  29. Bhurani D, Nair R, Rajappa S et al (2022) Real-world out-comes of Hodgkin lymphoma: a multi-centric registryfrom India. Front Oncol Front Oncol 11(11):799948

    Article  PubMed  Google Scholar 

  30. Boo YL, Ting HSY, Yap DFS, Toh SG, Lim SM (2019) Clinical features and treatment outcomes of Hodgkin lymphoma: a retrospective review in a Malaysian tertiary hospital. Blood Res 54(3):210–217

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Seshachalam A, Karpurmath SV, Rathnam K, Raman SG, Janarthinakani M, Prasad K, Patil C, Anoop P, Reddy N, Anumula SK, Roopa SP, Golamari KR, Danthala M, Gunari P, Malipatil B, Rangarajan B, Udupa KS, Nandennavar M, Niraimathi K, Shewade HD (2019) Does interim PET scan after 2 cycles of ABVD predict outcome in Hodgkin lymphoma? Real-world evidence. J Glob Oncol 5:1–13

    PubMed  Google Scholar 

  32. Yadav BS, Sharma SC, Malhotra P, Prakash G (2020) Combined modality treatment: Outcome in patients with Hodgkin’s lymphoma. J Cancer Res Ther 16(1):1–6

    Article  CAS  PubMed  Google Scholar 

  33. Nayak L, Jain H, Bonda A, Epari S, Laskar S, Gokarn A, Shet T, Gujral S, Khanna N, Bagal B, Punatar S, Goda J, Thorat J, Rengaraj K, Sengar M (2021) Hodgkin lymphoma in adolescent and young adults: real-world data from a single tertiary cancer center in India. J Adolesc Young Adult Oncol 10(5):581–587

    Article  PubMed  Google Scholar 

  34. Khattry N, Laskar S, Sengar M, Rangarajan V, Shet T, Subramanian PG, Epari S, Bagal B, Goda JS, Agarwal A, Jain H, Tembhare P, Patkar N, Khanna N (2018) Long term clinical outcomes of adult hematolymphoid malignancies treated at Tata Memorial Hospital: an institutional audit. Indian J Cancer 55(1):9–15

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank all the supporting departments of Kidwai Memorial Institute of Oncology.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Dr. M. H. Marigowda Road, Bengaluru, Karnataka, India

    Linu Abraham Jacob, Tarjina Begum, M. C. Suresh Babu, K. N. Lokesh, A. H. Rudresha, L. K. Rajeev & Smitha C. Saldanha

  2. Department of Medical Oncology, Medica Cancer Hospital, Rangapani, Siliguri, West Bengal, India

    Arkoprovo Halder

Authors
  1. Linu Abraham Jacob
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tarjina Begum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Arkoprovo Halder
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. C. Suresh Babu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K. N. Lokesh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. A. H. Rudresha
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. L. K. Rajeev
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Smitha C. Saldanha
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Linu Abraham Jacob.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jacob, L.A., Begum, T., Halder, A. et al. Clinical Profile and Outcome of Adult Classical Hodgkin’s Lymphoma: Real World Single Centre Experience. Indian J Hematol Blood Transfus (2024). https://doi.org/10.1007/s12288-024-01735-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12288-024-01735-9

Keywords

Search

Navigation