International Prognostic Score for Nodular Lymphocyte–Predominant Hodgkin Lymphoma-Reference-Cited by-同舟云学术

International Prognostic Score for Nodular Lymphocyte–Predominant Hodgkin Lymphoma

Published:2024-07-01 Issue:19 Volume:42 Page:2271-2280
ISSN:0732-183X
Container-title:Journal of Clinical Oncology
language:en
Short-container-title:JCO

Author:

Binkley Michael Sargent¹^ORCID,Flerlage Jamie E.²^ORCID,Savage Kerry J.³^ORCID,Akhtar Saad⁴,Steiner Raphael⁵^ORCID,Zhang Xiao-Yin⁶,Dickinson Michael⁷^ORCID,Prica Anca⁸,Major Ajay⁹^ORCID,Hendrickson Peter G.¹⁰,Hopkins David¹¹^ORCID,Ng Andrea¹²^ORCID,Casulo Carla¹³^ORCID,Baron Jonathan¹⁴^ORCID,Roberts Kenneth B.¹⁵^ORCID,Al Kendi Jalila¹⁶^ORCID,Balogh Alex¹⁷,Ricardi Umberto¹⁸^ORCID,Torka Pallawi¹⁹^ORCID,Specht Lena²⁰^ORCID,De Silva Ravindu²¹^ORCID,Pickard Keir²²^ORCID,Blazin Lindsay J²³^ORCID,Henry Michael²⁴,Smith Christine M.²⁵^ORCID,Halperin Daniel²⁶,Brady Jessica²⁷^ORCID,Brennan Bernadette²⁸,Senchenko Maria Anatolevna²⁹^ORCID,Reeves Marie³⁰,Hoppe Bradford S.³¹³²^ORCID,Terezakis Stephanie³³^ORCID,Talaulikar Dipti³⁴³⁵,Picardi Marco³⁶,Kirova Youlia³⁷,Fergusson Paige³⁸,Hawkes Eliza A.³⁹⁴⁰^ORCID,Lee Denise⁴¹,Doo Nicole Wong⁴⁰⁴²^ORCID,Barraclough Allison⁴³^ORCID,Cheah Chan Y.⁴⁴⁴⁵^ORCID,Ku Matthew⁴⁶⁴⁷^ORCID,Hamad Nada⁴⁸⁴⁹⁵⁰^ORCID,Mutsando Howard⁴⁹⁵¹,Gilbertson Michael⁵²^ORCID,Marconi Tamara⁵³^ORCID,Viiala Nicholas⁵⁴⁵⁵,Maurer Matthew J⁵⁶^ORCID,Eichenauer Dennis A⁵⁷^ORCID,Hoppe Richard T.¹^ORCID, ,Borchmann Peter,Fuchs Michael,Hartmann Sylvia,Eich Hans Theodor,Lo Andrea C.,Skinnider Brian,Rauf M. Shahzad,Maghfoor Irfan,Pinnix Chelsea C.,Milgrom Sarah A,Vega Francisco,Alomari Mohammed,Collins Graham P.,Advani Ranjana H.,Metzger Monika L.,Wirth Andrew,Tsang Richard,Smith Sonali,Kelsey Christopher R.,McKay Pamela,Koenig Julie,Constine Louis S.,Sakthivel Ku G.,Plastaras John P.,Gao Sarah,Al Rahbi Nasser,Levis Mario,Sridhar Akshay,Shah Nimish,Osborne Wendy,Chang Isabela,Miall Fiona,Mikhaeel George,Penn Anthony,Volchkov Egor Vasilevich,Della Pepa Roberta,Northend Michael,Opat Stephen,Salvaris Ross,Tedjaseputra Aditya,Palese Monica,Shankar Ananth,Natkunam Yasodha,Kelly Kara M.

Affiliation:

1. Department of Radiation Oncology, Stanford School of Medicine, Stanford University, Stanford, CA

2. Department of Oncology, St Jude Children's Research Hospital, Memphis, TN

3. BC Cancer, Vancouver, Canada

4. King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia

5. The University of Texas MD Anderson Cancer Center, Houston, TX

6. Oxford University, Oxford, United Kingdom

7. Peter MacCallum Cancer Centre, Melbourne, Australia

8. Princess Margaret Cancer Centre, Toronto, Canada

9. The University of Chicago, Chicago, IL

10. Duke University, Durham, NC

11. Department of Haematology, Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom

12. Dana-Farber Cancer Institute, Boston, MA

13. University of Rochester, Rochester, NY

14. University of Pennsylvania, Philadelphia, PA

15. Yale University, New Haven, CT

16. The Royal Hospital, Muscat, Oman

17. Tom Baker Cancer Centre, Calgary, Canada

18. Department of Oncology, University of Turin, Turin, Italy

19. Roswell Park Comprehensive Cancer Center, Buffalo, NY

20. Copenhagen University Hospital, Copenhagen, Denmark

21. Norfolk and Norwich University Hospital, Norfolk, United Kingdom

22. Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom

23. Division of Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN

24. Phoenix Children's Hospital, Phoenix, AZ

25. Vanderbilt University Medical Center, Nashville, TN

26. University Hospitals of Leicester NHS Trust, Leicester, United Kingdom

27. Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom

28. Manchester University NHS Foundation Trust, Manchester, United Kingdom

29. Oncology and Immunology, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Moscow, Russian Federation

30. Royal Manchester Children's Hospital, Manchester, United Kingdom

31. University of Florida, Gainesville, FL

32. Mayo Clinic, Jacksonville, FL

33. Johns Hopkins University, Baltimore, MD

34. Canberra Health Services, Canberra, Australia

35. College of Health and Medicine, Australian National University, Canberra, Australia

36. Department of Clinical Medicine and Surgery, AOU Federico II, Naples, Italy

37. Institute Curie, Paris, France

38. Birmingham Children's Hospital, Birmingham, United Kingdom

39. Olivia Newton-John Cancer Research Centre at Austin Health, Melbourne, Australia

40. Lymphoma and Related Diseases Registry, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

41. Austin Hospital, Eastern Health, Melbourne, Australia

42. Department of Haematology, Concord Hospital, Concord Clinical School, University of Sydney, Sydney, Australia

43. Department of Haematology, Fiona Stanley Hospital, Perth, Australia

44. Department of Haematology, Sir Charles Gairdner Hospital, Perth, Australia

45. Medical School, University of Western Australia, Perth, Australia

46. Department of Haematology, St Vincent's Hospital, Melbourne, Australia

47. University of Melbourne, Melbourne, Australia

48. Department of Haematology, St Vincent's Hospital Sydney, Sydney, Australia

49. Faculty of Medicine and Health, School of Clinical Medicine, UNSW Sydney, Sydney, Australia

50. School of Medicine, University of Notre Dame, Sydney, Australia

51. University of Queensland Rural Clinical School, Toowoomba, Australia

52. Monash University, Melbourne, Australia

53. Eastern Health, Melbourne, Australia

54. Department of Haematology, Liverpool Hospital, Liverpool, Australia

55. South West Sydney Clinical School, UNSW Medicine, Liverpool, Australia

56. Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN

57. Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University Hospital Cologne, German Hodgkin Study Group, Cologne, Germany

Abstract

PURPOSE Nodular lymphocyte–predominant Hodgkin lymphoma (NLPHL) is a rare cancer, and large international cooperative efforts are needed to evaluate the significance of clinical risk factors and immunoarchitectural patterns (IAPs) for all stages of pediatric and adult patients with NLPHL. METHODS Thirty-eight institutions participated in the Global nLPHL One Working Group retrospective study of NLPHL cases from 1992 to 2021. We measured progression-free survival (PFS), overall survival (OS), transformation rate, and lymphoma-specific death rate. We performed uni- and multivariable (MVA) Cox regression stratified by management to select factors for the lymphocyte-predominant international prognostic score (LP-IPS) validated by five-fold cross-validation. RESULTS We identified 2,243 patients with a median age of 37 years (IQR, 23-51). The median follow-up was 6.3 years (IQR, 3.4-10.8). Most had stage I to II (72.9%) and few B symptoms (9.9%) or splenic involvement (5.4%). IAP was scored for 916 (40.8%). Frontline management included chemotherapy alone (32.4%), combined modality therapy (30.5%), radiotherapy alone (24.0%), observation after excision (4.6%), rituximab alone (4.0%), active surveillance (3.4%), and rituximab and radiotherapy (1.1%). The PFS, OS, transformation, and lymphoma-specific death rates at 10 years were 70.8%, 91.6%, 4.8%, and 3.3%, respectively. On MVA, IAPs were not associated with PFS or OS, but IAP E had higher risk of transformation (hazard ratio [HR], 1.81; P < .05). We developed the LP-IPS with 1 point each for age ≥45 years, stage III-IV, hemoglobin <10.5 g/dL, and splenic involvement. Increasing LP-IPS was significantly associated with worse PFS (HR, 1.52) and OS (HR, 2.31) and increased risk of lymphoma-specific death (HR, 2.63) and transformation (HR, 1.41). CONCLUSION In this comprehensive study of all ages of patients with NLPHL, we develop the LP-IPS to identify high-risk patients and inform upcoming prospective clinical trials evaluating de-escalation of therapy for patients with low LP-IPS scores (<2).

Publisher

American Society of Clinical Oncology (ASCO)

Link

https://ascopubs.org/doi/pdfdirect/10.1200/JCO.23.01655

Reference25 articles.

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2. Pitfalls in the Diagnosis of Nodular Lymphocyte Predominant Hodgkin Lymphoma: Variant Patterns, Borderlines and Mimics

3. Long-Term Follow-Up of Patients With Nodular Lymphocyte-Predominant Hodgkin Lymphoma Treated in the HD7 to HD15 Trials: A Report From the German Hodgkin Study Group

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