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Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India

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Abstract

Early-stage Hodgkin's lymphoma (ESHL) is highly curable, usually with a combination of chemotherapy and radiation. Real-world data may show differences in survival and prognostic factors when compared to clinical trials. There is limited published literature on ESHL from India. The data on the baseline characters, treatment, and outcomes of patients with ESHL (stage IA, IB, and IIA) were obtained from five institutions' medical records and entered in a common database. Event-free survival (EFS) and overall survival (OS) were estimated using the Kaplan Meier method, and cox-regression analysis was used to identify prognostic factors. There were 258 patients [median age was 37 (18–75) years; [males:160 (62%); stage I: 41%; B symptoms: 17 (6%); bulky disease:19 (15%)] treated between 2000 and 2020 who were evaluable. The common chemotherapies used were ABVD [N = 180 (70%)], COPP-ABVD hybrid [N = 52 (21%)], and COPP [N = 14 (5%)]. Median number of cycles were 4 (2–8) and 93 (47%) received radiation at end of treatment. After a median follow-up of 60 months, the 5 years EFS was 87% and OS was 92%. On multivariate analysis, the following factors adversely affected the EFS: Male gender [hazard ratio (HR) = 2.23, P = 0.02] and Hemoglobin < 10.5g/dL [hazard ration (HR) = 2.20, P = 0.02], and the following adversely affected the OS: Hemoglobin < 10.5g/dL [hazard ratio (HR) = 4.05, P = 0.001], Male gender [hazard ratio (HR) = 3.59, P = 0.004], Stage 2 [hazard ratio (HR) = 2.65, P = 0.002] and ECOG PS (2–3) [hazard ratio (HR) = 3.35, P = 0.01]. Using the hemoglobin, stage and gender a 3-item prognostic score could identify patients with very good outcomes (score 0; 5 years OS:100%) and poor outcomes (score 3; 5 years OS; 49%). This is one of the first multi-center real-world data exclusively focusing on ESHL from India. Though the survival of the entire population was good, there are subsets of patients who have poor outcomes, which may be identified using simple parameters. These parameters need validation in a larger dataset.

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Authors and Affiliations

  1. Department of Medical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), 3rd Floor, SSB, Dhanvantari Nagar, Puducherry, 605006, India

    Lakshmi Sandhya Singuluri, Luxitaa Goenka, Biswajit Dubashi & Prasanth Ganesan

  2. Department of Medical Oncology, Cancer Institute (WIA), Chennai, India

    Perumal Kalaiyarasi Jayachandran, Nikita Mehra, Mummoorthy Ram Kumar, Murugan Mangai Suseela & Manikandan Dhanushkodi

  3. Department of Clinical Hematology and Medical Oncology, Malabar Cancer Center, Thalassery, India

    Praveen Kumar Shenoy, Vineetha Raghavan & Chandran K. Nair

  4. Department of Medical Oncology, Madurai Meenakshi Mission Hospital and Research Center, Madurai, India

    Krishna Kumar Rathnam

  5. Department of Medical Oncology, GVN Hospital, Trichy, India

    Arun Seshachalam

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  1. Lakshmi Sandhya Singuluri
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Singuluri, L.S., Jayachandran, P.K., Goenka, L. et al. Prognostic Factors and Outcomes of Early-Stage Hodgkin’s Lymphoma: Multi-Institutional Data From South India. Indian J Hematol Blood Transfus 40, 237–245 (2024). https://doi.org/10.1007/s12288-023-01692-9

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  • DOI: https://doi.org/10.1007/s12288-023-01692-9

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