A analysis of the outcome and prognostic factors in 415 patients with Hodgkin lymphoma

Objective: The aim of this study was to investigate the effectiveness of treatment, survival and prognostic factors in Chinese patients with Hodgkin lymphoma. Methods: A total of previously untreated 415 patients with histologically confirmed Hodgkin lymphoma admitted in the Cancer Hospital, Chinese Academy of Medical Sciences from February 1999 to February 2011 were included in this study. Their short-term and long-term survivals, as well as prognostic factors were analyzed. Results: For the whole group, 371 cases (89.4%) had complete remission (CR) , 33 cases (8.0%) had partial remission (PR) and II cases (2.7%) experienced disease progression. The CR rales lor stage I , II , III and IV patients were 96.6% (56/58), 92.0% (219/238), 83.6% (51/61) and 77.6% (45/58), respectively (P< 0.001 ). The 5-year disease-free survival( DFS) , progression-free survival (PFS) and overall survival (OS) were 90.6%, 84.1% and 92.5%. The stage I - II patients were significantly belter than stage III-IV patients in terms of 5-year DFS rate( 94.5% vs. 79.2% , P< 0.001) , 5-year PFS rate (91.2% vs. 66.4%, P< 0.001) and 5-year OS rate (97.0% vs. 81.5%, P< 0.001). For stage I -II patients, combined modality therapy was related to better DFS, PFS and OS as compared with radiotherapy alone, and was associated with a better PFS compared with chemotherapy alone. There was a trend that consolidative radiotherapy could improve the long-term survival for stage III-IV patients who achieved disease remission after chemotherapy. What's more, consolidative radiotherapy could significantly improve PFS for those stage III-IV patients who achieved PR after chemotherapy. Multivariate analysis showed that clinical stage and pathological type were independent prognostic factors for the 5-year DFS rate (both P < 0.05) , and the stage, elevated serum β2-microglobulin and none-ABVD/BEACOP chemotherapy regimen were independent prognostic factors for 5-year PFS rate and 5-year overall survival rale ( P< 0.05 for all). Conclusions: Patients with HL treated in China have a good prognosis. Combined modality therapy is the preferred treatment for stage I -II patients. Consolidative radiotherapy is recommended to those of stage III-IV patients who experienced PR after chemotherapy. Stage, serum β2-microglobulin and first-line chemotherapy regimen significantly affect the prognosis for patients with Hodgkin lymphoma.