International Journal of Hematology

, Volume 91, Issue 3, pp 446–455

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

  • Kuniaki Itoh
  • Tomohiro Kinoshita
  • Takashi Watanabe
  • Kenichi Yoshimura
  • Rumiko Okamoto
  • Takaaki Chou
  • Michinori Ogura
  • Masami Hirano
  • Hideki Asaoku
  • Mitsutoshi Kurosawa
  • Yoshiharu Maeda
  • Ken Omachi
  • Yukiyoshi Moriuchi
  • Masaharu Kasai
  • Kazunori Ohnishi
  • Nobuyuki Takayama
  • Yasuo Morishima
  • Kensei Tobinai
  • Harumi Kaba
  • Seiichiro Yamamoto
  • Haruhiko Fukuda
  • Masahiro Kikuchi
  • Tadashi Yoshino
  • Yoshihiro Matsuno
  • Tomomitsu Hotta
  • Masanori Shimoyama
Original Article

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 

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Copyright information

© The Japanese Society of Hematology 2010

Authors and Affiliations

  • Kuniaki Itoh
    • 1
  • Tomohiro Kinoshita
    • 2
  • Takashi Watanabe
    • 3
  • Kenichi Yoshimura
    • 4
  • Rumiko Okamoto
    • 5
  • Takaaki Chou
    • 6
  • Michinori Ogura
    • 7
  • Masami Hirano
    • 8
  • Hideki Asaoku
    • 9
  • Mitsutoshi Kurosawa
    • 10
  • Yoshiharu Maeda
    • 5
  • Ken Omachi
    • 11
  • Yukiyoshi Moriuchi
    • 12
  • Masaharu Kasai
    • 13
  • Kazunori Ohnishi
    • 14
  • Nobuyuki Takayama
    • 15
  • Yasuo Morishima
    • 7
  • Kensei Tobinai
    • 3
  • Harumi Kaba
    • 4
  • Seiichiro Yamamoto
    • 4
  • Haruhiko Fukuda
    • 4
  • Masahiro Kikuchi
    • 16
  • Tadashi Yoshino
    • 17
  • Yoshihiro Matsuno
    • 18
  • Tomomitsu Hotta
    • 19
  • Masanori Shimoyama
    • 20
  1. 1.Division of Oncology and HematologyNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Department of Hematology and OncologyNagoya University Graduate School of MedicineNagoyaJapan
  3. 3.Hematology DivisionNational Cancer Center HospitalTokyoJapan
  4. 4.Clinical Trials and Practice Support Division, Center for Cancer Control and Information ServicesNational Cancer CenterTokyoJapan
  5. 5.Department of ChemotherapyTokyo Metropolitan Cancer and Infectious Diseases Center, Komagome HospitalTokyoJapan
  6. 6.Department of Internal MedicineNiigata Cancer Center HospitalNiigataJapan
  7. 7.Department of Hematology and Cell TherapyAichi Cancer CenterNagoyaJapan
  8. 8.Department of HematologyFujita Health University School of MedicineToyoakeJapan
  9. 9.Clinical LaboratoryHiroshima Red Cross Hospital, Atomic-Bomb Survivors HospitalHiroshimaJapan
  10. 10.Department of Hematology, National Hospital OrganizationHokkaido Cancer CenterSapporoJapan
  11. 11.Department of Hematology and OncologyTokai University School of MedicineIseharaJapan
  12. 12.Department of HematologySasebo Municipal General HospitalSaseboJapan
  13. 13.Department of HematologySapporo Hokuyu HospitalSapporoJapan
  14. 14.Department of Internal MedicineHamamatsu University School of MedicineHamamatsuJapan
  15. 15.Second Department of Internal MedicineKyorin UniversityMitakaJapan
  16. 16.Department of Pathology, School of MedicineFukuoka UniversityFukuokaJapan
  17. 17.Department of PathologyOkayama University, Medical SchoolOkayamaJapan
  18. 18.Department of Surgical PathologyHokkaido UniversitySapporoJapan
  19. 19.National Hospital OrganizationNagoya Medical CenterNagoyaJapan
  20. 20.National Cancer Center HospitalTokyoJapan

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