Pathology & Oncology Research

, Volume 14, Issue 4, pp 411–421 | Cite as

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL)—Clinicopathological Features Based on the Data of Two Hungarian Lymphoma Centres

  • Á. Illés
  • Zs Simon
  • E. Tóth
  • A. Rosta
  • Zs Miltényi
  • Zs Molnár
Original Paper

Abstract

Clinicopathological features of nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) differ from those of the classical Hodgkin lymphoma (cHL). Our aim was to examine clinical presentation, therapeutic and survival results of NLPHL patients in Hungary based on the data of two centres, and incidentally we analyzed the clinicopathological characteristics and differential diagnostic difficulties of this rare entity. We analyzed the clinical features, treatment and survival data of 536 Hodgkin lymphoma patients who had been diagnosed and primarily treated in our institutes between 1995 and 2004. Mean follow-up time was 82.7 (3–144) months of the total 536 HL patients. Sixteen (3%) of the patients were diagnosed with NLPHL, 93% of them presented with early-stage disease. None of the patients showed extranodal or splenic involvement or bulky disease. One patient received chemotherapy alone, six received only involved field radiotherapy while six underwent combined modality treatment. We applied watch and wait strategy in three cases. Overall response rate was 100% (93.75% complete). Two NLPHL cases transformed to non-Hodgkin’s lymphoma. In contrast to the classical HL, the 10-year prognosticated overall survival rate was 100 vs. 82%, the event free survival was: 75% vs. 70%. In NLPHL group there were no late or multiple relapses and none of them died. Conclusions: NLPHL is a rare disease, thus these are limited experiences with its diagnosis and treatment. Since the disease has an excellent outcomeit is very important to prefer less toxic or local therapies to reach long term survival similar to that of the normal population.

Keywords

Nodular lymphocyte predominant Hodgkin lymphoma Classical Hodgkin lymphoma Differential diagnosis Immunohistochemistry Treatment Prognosis 

Abbreviations

ABVD

adriamycine, vinblastine, dacarbazine, bleomycine

aHSCT

autologous hemopoetic stem cell transplantation

ALCL

anaplastic large cell lymphoma

BEACOPP

bleomycine, etoposid, adriamycine, cyclophosphamide, vincristin, procarbazine, prednisolone

CEP CCNU

etoposid, prednimustin

cHL

classical Hodgkin lymphoma

CMT

combined modality treatment

CRu

undetermined complete remission

COPP/ABV

cyclophosphamide, vincristin, procarbazine/adriamycine, bleomycine, vinblastine

CR

complete remission

CVP

cyclophosphamide, vincristin, prednisolone

DHAP

dexamethasone, cytarabin, cisplatine

DLBCL

diffuse large B-cell non-Hodgkin lymphoma

EBV

Epstein-Barr virus

EFRT

extended field radiotherapy

EFS

event-free survival

EMA

epithelial membrane antigen

EORTC

European Organization for Research and Treating Cancer

ETFL

European Task Force on Lymphoma

FDC

follicular dendritic cell

FDG

18-fluoro deoxyglucose

GSHG

German Study Hodgkin Group

HD

Hodgkin’s disease

HDT

high dose therapy

HE

haematoxylin-eosin

HRS

Hodgkin, Reed-Sternberg cells

IFRT

involved field radiotherapy

INRT

involved nodal radiotherapy

IPS

International Prognostic Score

L&H

lymphocyte and histiocyte cell

LD

lymphocyte depletion

LMP

latent membrane protein

LPHD

lymphocyte predominant Hodgkin’s disease

LRcHL

lymphocyte rich classical Hodgkin lymphoma

MC

mixed cellularity

NLPHL

nodular lymphocyte predominant Hodgkin lymphoma

NR

non-responder

NS

nodular sclerosing

ORR

overall response rate

OS

overall survival

PET

positron emission tomography

PR

partial remission

PTCG

progressive transformed germinal centre

(R)-CHOP

(rituximab)-cyclophosphamide, adriamycine, vincristin, prednisolone

REAL

Revised European and American Lymphoma classification

T/HrBCL

T-cell/histiocyte rich B-cell lymphoma

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Copyright information

© Arányi Lajos Foundation 2008

Authors and Affiliations

  • Á. Illés
    • 1
  • Zs Simon
    • 1
  • E. Tóth
    • 2
  • A. Rosta
    • 2
  • Zs Miltényi
    • 1
  • Zs Molnár
    • 2
  1. 1.3rd Department of Institute for Internal Medicine, Medical and Health Science CentreUniversity of DebrecenDebrecenHungary
  2. 2.National Institute of OncologyBudapestHungary

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