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Stadien IIIB und IVB des Morbus Hodgkin Ansprechbarkeit auf Chemotherapie, Rezidive, Überlebensraten

Stage IIIB and IVB Hodgkin's disease response to chemotherapy, relapses, survival rates

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Summary

Thirty-two of 71 (45%) stage IIIB and IVB patients up to the age of 60 achieved a complete remission (CR) by initial COPP-chemotherapy. Twelve additional cases were free of symptoms after COPP, but showed persistent disease at postprimary laparotomy or within 3 months after cessation of chemotherapy. Forty-four per cent (n=17) of the initial COPP failures could also be brought to CR by ABVD-chemotherapy or/and radiotherapy within 7 to 51 months. Cases with lymphocytic depletion reached CR in only 31% (n=5/16) in comparison to 80% (n=44/55) of the three other histological subtypes. Without additional consolidation therapy 60% relapsed, but only 11% after adjuvant total-nodal irradiation. An increase of side effects after therapy has not been observed so far. Patients with once attained CR have a survival probability of 93% after nearly 8 years from diagnosis. For the whole stage IIIB/IVB group the values were 85% up to the age of 30 (n=28) and 60% for the age group of 31–60 (n=43). They were clearly higher than in the 1966–1971 patients who showed values of 39% and 41%, respectively. Beyond the age of 60 (n=15) the survival probability of 10% after 3 years in comparison to former 15% revealed no improvement.

Zusammenfassung

Durch initiale COPP-Theapie ließen sich bei 32 von 71 (45%) Patienten bis zum 60. Lebensjahr (LJ) mit den Stadien IIIB (n=53) und IVB (n=18) Vollremissionen (VR) erzielen. 12 weitere Fälle waren nach COPP zwar symptomenfrei, zeigten aber bei der postprimären explorativen Laparotomie oder innerhalb von drei Monaten nach Therapieende doch noch Krankheitsherde. 44% (n=17) der initialen COPP-Versager konnten durch ABVD oder/und Radiotheapie nach insgesamt 7–51 Monaten ebenfalls in eine VR übergeführt werden. Bei lymphozytenarmer Histologie waren nur in 31% (n=5/16) Vollremissionen gegenüber 80% (n=44/55) bei den anderen drei Subtypen möglich. Ohne Konsolidierungstherapie kam es in knapp 60%, nach adjuvanter totalnodaler Bestrahlung nur in 11% zu Rezidiven. Therapiekomplikationen haben bisher nicht zugenommen. Patienten mit einer eimal erreichten VR (n:49/71=69%) hatten nach knapp 8 Jahren eine Überlebenswahrscheinlichkeit von 93% ab Diagnose. Diese betrug in der Gesamtheit der Stadien IIIB und IVB 85% für Patienten bis zum 30. LJ (n=28) und 60% für das 31.–60. LJ (n=43). Sie lag damit deutlich höher als im Kollektiv der Jahre 1966–1971 mit Werten von 39% bzw. 41% für beide Altersgruppen. Jenseits des 60. LJ (n=15) fand sich mit 10% gegenüber 15% nach 3 Jahren keine Verbesserung der Überlebensraten.

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Author notes

  1. A. Calavrezos

    Present address: 2. Medizinische Abteilung des Allgemeine Krankenhauses Hamburg-Harburg, Germany

Authors and Affiliations

  1. Hämatologische Abteilung des Allgemeinen Krankenhauses St. Georg, Hamburg

    R. Kuse, A. Calavrezos, A. Hinrichs & K. Hausmann

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  1. R. Kuse
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  2. A. Calavrezos
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  3. A. Hinrichs
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  4. K. Hausmann
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Mit personeller Unterstützung durch das Tumorzentrum Hamburg

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Kuse, R., Calavrezos, A., Hinrichs, A. et al. Stadien IIIB und IVB des Morbus Hodgkin Ansprechbarkeit auf Chemotherapie, Rezidive, Überlebensraten. Klin Wochenschr 59, 737–742 (1981). https://doi.org/10.1007/BF01721261

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