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Clinico-Epidemiological Profile, Prognostic Factors and Treatment Outcome of Refractory Hodgkin Lymphoma
Indian Journal of Hematology and Blood Transfusion ( IF 0.9 ) Pub Date : 2021-07-03 , DOI: 10.1007/s12288-021-01463-4
Yosr Zenzri 1 , Amina Mokrani 1 , Feryel Letaief 1 , Mouna Ayadi 1 , Amel Mezlini 1
Affiliation  

Approximately 5–10% of patients with Hodgkin lymphoma are refractory to initial treatment. The aim of our study was to assess the clinico-epidemiological profile, prognostic factors and treatment outcome. A retrospective study was conducted over a period of 12 years between June 2006 and January 2018 at the oncology department of Salah Azaïz Institute. Thirty-one patients were included. The median age was 27 years with a female predominance (sex ratio = 0.93).The majority had an advanced stage (61%). IGEV regimen was the most commonly used salvage chemotherapy (n = 14). Age above 30 years was predictive of treatment failure after salvage therapy (p = 0.003). IGEV regimen showed better results than ICE protocol in terms of response to salvage therapy (p = 0.048). Seven patients had salvage radiotherapy. Four patients had autologous stem cell transplant. Progressive disease (n = 12) was the main cause of non-eligibility of autologous stem cell tansplant. Overall survival and progression free survival at 3 years were 50% and 5% respectively. The prognostic factors influencing the overall survival were age above 30 years (p = 0.001), advanced Ann Arbor stage before progression (p = 0.02), advanced Ann Arbor stage of refractory Hodgkin lymphoma (p = 0.001), histological subtype (p = 0.001), CD20 expression (p = 0.027) and non-response to salvage therapy (p = 0.004). The prognostic factor influencing progression free survival was the non-response to salvage therapy (p = 0.045). The prognosis of refractory Hodgkin lymphoma remains poor. The current standard secondary treatment consists of combination therapy, usually followed by autologous stem cell transplantat. Innovative therapies are needed to improve the prognosis of refractory Hodgkin lymphoma.



中文翻译:

难治性霍奇金淋巴瘤的临床流行病学概况、预后因素和治疗结果

大约 5-10% 的霍奇金淋巴瘤患者对初始治疗难以治愈。我们研究的目的是评估临床流行病学特征、预后因素和治疗结果。一项回顾性研究于 2006 年 6 月至 2018 年 1 月期间在 Salah Azaïz 研究所的肿瘤科进行,历时 12 年。包括 31 名患者。中位年龄为 27 岁,女性居多(性别比 = 0.93)。大多数患者已处于晚期 (61%)。IGEV 方案是最常用的挽救化疗 (n = 14)。年龄超过 30 岁是挽救治疗后治疗失败的预测因素 ( p  = 0.003)。IGEV 方案在对挽救治疗的反应方面比 ICE 方案显示出更好的结果(p = 0.048)。七名患者接受了挽救性放疗。四名患者进行了自体干细胞移植。进行性疾病 (n = 12) 是自体干细胞移植不合格的主要原因。3 年总生存率和无进展生存率分别为 50% 和 5%。影响总生存期的预后因素为年龄大于 30 岁 ( p  = 0.001)、进展前 Ann Arbor 分期晚期 ( p  = 0.02)、难治性霍奇金淋巴瘤晚期 Ann Arbor 分期 ( p  = 0.001)、组织学亚型 ( p  = 0.001) )、CD20 表达 ( p  = 0.027) 和对补救治疗无反应 ( p = 0.004)。影响无进展生存期的预后因素是对挽救治疗无反应 ( p  = 0.045)。难治性霍奇金淋巴瘤的预后仍然很差。目前的标准二级治疗包括联合治疗,通常随后进行自体干细胞移植。需要创新疗法来改善难治性霍奇金淋巴瘤的预后。

更新日期:2021-07-04
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