Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan
First Online: 03 March 2010 Received: 06 July 2009 Revised: 05 February 2010 Accepted: 08 February 2010 DOI:
10.1007/s12185-010-0533-9 Cite this article as: Itoh, K., Kinoshita, T., Watanabe, T. et al. Int J Hematol (2010) 91: 446. doi:10.1007/s12185-010-0533-9 Abstract
The Japan Clinical Oncology Group conducted two multicenter phase II trials in 200 patients with advanced Hodgkin lymphoma (HL) in the 1990s. Among 181 patients whose histopathological specimens were available and reviewed by 6 hematopathologists, 167 (92.3%) were diagnosed with HL. Five-year overall survival (OS) among these 167 patients was 88.3%, including 89.2% among nodular sclerosis and 82.2% among mixed cellularity cases. International prognostic score was not closely associated with OS. Seven unfavorable prognostic factors for OS on univariate analysis were male, B symptoms, clinical stage of III or IV, elevated serum LDH, elevated alkaline phosphatase, elevated β2-microglobulin, and pathological subtype (mixed cellularity and lymphocyte depletion). On multivariate analysis, male [HR 3.30 (95% CI 1.15–9.52,
p = 0.027)] and elevated serum LDH [HR 2.41 (95% CI 1.07–5.43, p = 0.034)] were independent factors for OS. Based on these prognostic factors, the 5-year OS was 95.7% in the low-risk group (no adverse factor), 87.9% in the intermediate-risk group (1 adverse factor) and 73.3% in the high-risk group (2 adverse factors). This simple prognostic model for HL warrants further validation studies. Keywords International prognostic score Multicenter phase II trial Prognostic factor Overall survival Male gender LDH
On behalf of Japan Clinical Oncology Group (JCOG)–Lymphoma Study Group (LSG).
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