Failure Pattern of Treatment of Hodgkin Lymphoma -- Retrospective from a Single Institution

Backgound:

Hodgkin lymphoma is a highly curable malignant disease by chemotherapy or chemoradiation. However, there is still small percentage of patients can not achieved complete remission or relapsed later then died of disease refractoriness. We investigated the treatment failure pattern in those relapsed and refractory patients.

Method:

This is a retrospective study of patients treated at our institute in ten years with ABVD +/- RT. For relapsed patients, the salvage chemotherapy includes DHAP, ICE, or GDP, and patients may undergo high dose chemotherapy plus hematopoietic stem cell transplantation when second remission achieved.

Results:

Between 2002 and 2012, we have treated 108 patients of Hodgkin lymphom and the ten-year overall survival was 92% with stage I and II (N=63) versus III and IV (N=45) were 100% and 80%, respectively. Twenty patients got disease relapsed after ABVD +/- RT with 6 patients died of disease refractoriess and 14 patients achieved second remission after salvage chemotherapy then underwent hematopoietic stem cell transplantation with 11 survived over ten years. In these 20 relapsed patients, the initial involved sites include lung (n=8), bone (n=5),bone marrow (n=5), liver (n=3), mediastinal bulky (n=2), nodal only (n=2).

Conclusion:

Stage IV with extramedullary involvement over lung, bone, bone marrow and liver are high risk for treatment failure and earlier intensive treatment is warranted.