Sociedad Argentina de Hematología

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Revista Argentina de Hematología


Volumen:    22    # Number : 3

Publication Date :    Septiembre - Diciembre    Year:    2018


Clinical and immunohistochemical adverse prognostic factors in Hodgkin lymphoma. Experience in an argentinian institution

Authors: Kalmus M, González M, Narbaitz M, Metrebian F, Zabaljauregui S, Rodríguez A

Abstract: The use of risk stratification tools for an accurate prediction of the outcome in Hodgkin lymphoma (HL) patients at the time of diagnosis is crucial in order to achieve a personalized management, in an era where the goal is to individualize the therapeutic schemes in order to maximize effectiveness and reduce toxicity, scalating treatment in patients who suffer from high-risk diseases and reducing intensity in those with more benign ones. However, most of the classic factors currently used for predicting outcome in patients with HL were described more than 15 years ago and in more recent studies their prognostic value has not been confirmed. The aim of this retrospective observational study was to assess the clinical and immunohistochemical characteristics and their prognostic impact in patients with HL in an Argentinian institution. One hundred and twenty patients were included, with a mean follow up of 72 months. Failure free progression (FFP) and overall survival (OS) at 5 years were 74% and 84%, respectively. The International Prognostic Score (IPS) remained prognostic both for FFP (p = 0,01) and for OS (p < 0,001). However, in the multivariate analysis only 1 variable (age) was significant for the FFP and 3 variables (age, stage and hemoglobin (ASH)) for the OS. A prognostic index composed by these 3 factors (ASH) allowed to discriminate patients -according to the presence of 0, 1 or 2 or more of these factors- in 3 risk groups for both FFP (p = 0,002) and OS (p < 0,001). This simplified prognostic model showed greater predictive power than the IPS and it might be able to identify a very high risk group (patients with 2 or more factors) with a 5 year-FFP and a 5 year-OS below 60%.

Key words: Hodgkin lymphoma, prognostic factors, International Prognostic Score

Pages : 261-268

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