Better Prognosis for Patients with Lymphocyte-predominant Hodgkin’s Lymphoma
A recent study compared lymphocyte-predominant Hodgkin’s lymphoma (LPHL) and classical Hodgkin’s lymphoma (cHL) in order to define differences in patient characteristics and possible treatment options for both types of disease. These results were published in the Journal of Clinical Oncology.
Hodgkin’s lymphoma is a type of cancer that originates in immune cells. It is estimated that 7,350 individuals are diagnosed with Hodgkin’s lymphoma annually in the United States. Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads through the lymph system in a predictable manner. It may spread outside the lymph system to other organs such as the lungs, liver, bone, and bone marrow.
Hodgkin’s lymphoma is classified into two distinct groups based on appearance of cancerous cells under the microscope: LPHL, which accounts for only 5% of HL diagnoses, and cHL, the more common form. The two variations of HL are differentiated by the size, shape, and types of lymphatic cells affected as well as the presence or absence of Reed Sternberg cells, which typically occur among patients with cHL. In addition, LPHL tends to be less aggressive than cHL.
Because cHL comprises 95% of HL cases, the majority of clinical trials evaluating novel therapeutic options have included cHL. In order to better understand characteristics of LPHL, researchers from Germany conducted an analysis of 8,298 HL patients treated within a German medical trial to compare patient characteristics and treatment outcomes among cHL patients and others diagnosed with LPHD.
Results of the study indicated that following first-line treatment, complete remission and unconfirmed complete remissions were achieved as described below in the following groups of patients:
- Among patients considered to have an early-stage favorable prognosis, remission and unconfirmed complete remissions were achieved in 91.6% of patients with LPHL compared with 85.9% of patients with cHL.
- For patients diagnosed with early, unfavorable HL, 85.7% of patients with LPHL achieved remission or unconfirmed complete remission compared with 83.3% for those with cHL.
- Among patients with advanced stages of LPHL, only 76.8% achieved remission or unconfirmed complete remission compared with 77.8% of the cHL patients.
The following results were also reported:
- There was no progression of cancer or recurrence after an average of 50 months for 88% of those diagnosed with LPHL who responded to therapy and for 82% of cHL patients who responded to therapy.
- Overall survival was slightly improved for the LPHL patients at 96% compared with 92% for the patients diagnosed with cHL.
- Factors that were associated with poorer outcomes for LPHL patients included advanced stage of disease, low red blood cell counts, and low white blood cell counts. Factors negatively affecting overall survival for LPHL patients included age of more than 45 years, advanced disease stages, and low red blood cell counts.
These results indicate that the better prognosis of LPHL, particularly among patients with early-stage disease, may allow for different treatment options from cHL.
Patients are encouraged to speak with their physician about treatment options for their specific diagnosis.
Reference: Nogova, L., Reineke, T., Brillant, C. et al. Lymphocyte-predominant and classical Hodgkin’s lymphoma: A comprehensive analysis from the German Hodgkin study group. Journal of Clinical Oncology. 2008. Vol. 26(3) 434-439.