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Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan

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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.

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Acknowledgments

We thank Kiyoshi Mukai (Tokyo Medical University), Shigeo Nakamura (Nagoya University), and Kouichi Ohshima (Kurume University) for pathological review as members of an expert panel. This study was supported by Grants-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare of Japan (2S-1, 5S-1, 8S-1, 11S-1, 11S-4, 14S-1, 14S-4, 17S-1, 17S-5).

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Authors and Affiliations

  1. Division of Oncology and Hematology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Kuniaki Itoh

  2. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Tomohiro Kinoshita

  3. Hematology Division, National Cancer Center Hospital, Tokyo, Japan

    Takashi Watanabe & Kensei Tobinai

  4. Clinical Trials and Practice Support Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan

    Kenichi Yoshimura, Harumi Kaba, Seiichiro Yamamoto & Haruhiko Fukuda

  5. Department of Chemotherapy, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan

    Rumiko Okamoto & Yoshiharu Maeda

  6. Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan

    Takaaki Chou

  7. Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan

    Michinori Ogura & Yasuo Morishima

  8. Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan

    Masami Hirano

  9. Clinical Laboratory, Hiroshima Red Cross Hospital, Atomic-Bomb Survivors Hospital, Hiroshima, Japan

    Hideki Asaoku

  10. Department of Hematology, National Hospital Organization, Hokkaido Cancer Center, Sapporo, Japan

    Mitsutoshi Kurosawa

  11. Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan

    Ken Omachi

  12. Department of Hematology, Sasebo Municipal General Hospital, Sasebo, Japan

    Yukiyoshi Moriuchi

  13. Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan

    Masaharu Kasai

  14. Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

    Kazunori Ohnishi

  15. Second Department of Internal Medicine, Kyorin University, Mitaka, Japan

    Nobuyuki Takayama

  16. Department of Pathology, School of Medicine, Fukuoka University, Fukuoka, Japan

    Masahiro Kikuchi

  17. Department of Pathology, Okayama University, Medical School, Okayama, Japan

    Tadashi Yoshino

  18. Department of Surgical Pathology, Hokkaido University, Sapporo, Japan

    Yoshihiro Matsuno

  19. National Hospital Organization, Nagoya Medical Center, Nagoya, Japan

    Tomomitsu Hotta

  20. National Cancer Center Hospital, Tokyo, Japan

    Masanori Shimoyama

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  1. Kuniaki Itoh
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  2. Tomohiro Kinoshita
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Corresponding author

Correspondence to Kuniaki Itoh.

Additional information

On behalf of Japan Clinical Oncology Group (JCOG)–Lymphoma Study Group (LSG).

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Itoh, K., Kinoshita, T., Watanabe, T. et al. Prognostic analysis and a new risk model for Hodgkin lymphoma in Japan. Int J Hematol 91, 446–455 (2010). https://doi.org/10.1007/s12185-010-0533-9

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  • DOI: https://doi.org/10.1007/s12185-010-0533-9

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