Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study

ABSTRACT

Objectives

To analyze the clinical characteristics and prognosis of primary extranodal classical Hodgkin lymphoma (PE-cHL).

Methods

Clinical features and outcomes of 22 PE-cHL patients who received initial chemotherapy January 2008 to January 2018 were analyzed retrospectively, and compared with 274 primary nodal Hodgkin lymphoma (PN-cHL) patients treated in the same period.

Results

With a median follow-up period of 42 months, compared with 274 PN-cHL patients, no significant difference of overall response rate (ORR) or complete remission (CR) rate was found, but the PE-cHL patients showed a higher recurrence rate (36.4% vs. 13.1%, p = .003) and poorer survival [(5-year overall survival (OS) rate: 64.6% vs. 97.7%, p = .001; 5-year progression-free survival (PFS) rate: 42.4% vs. 82.2%, p < .001)]. To minimize the effects of confounding factors, PE-cHL patients were matched with PN-cHL patients at a ratio of 1:1 according to age, gender, histological types and stage. Compared with 22 matched PN-cHL cases, PE-cHL was still associated with poor PFS (5-year PFS: 42.4% vs. 79.9%, p = .004). As to 22 PE-cHL patients, univariate analysis showed elevated serum lactate dehydrogenase (LDH) and elevated platelet (PLT) were associated with poor PFS (p < .05).

Discussion

Compared with PN-cHLs, PE-cHLs showed a considerable shorter duration of remission, higher recurrence tendency and poorer survival, indicating that more intensive therapy may be needed.

Conclusion

The prognosis of PE-cHL is unfavorable. Elevated LDH and PLT are poor prognostic factors for PE-cHL.

KEYWORDS:

• Hodgkin lymphoma
• primary extranodal
• clinical characteristics
• overall survival
• progression-free survival
• prognostic factors

Acknowledgments

The authors thank M.S. Lan Mi for statistical method supporting.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Mingzi Yang is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Lingyan Ping is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Weiping Liu is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Yan Xie is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Aliya is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Yanfei Liu is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Reyizha Nuersulitan is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Jun Zhu is the chief of department of lymphoma, Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Meng Wu is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Yuqin Song is a doctor of department of lymphoma at Peking University Cancer Hospital & Institute. The interested research area of the author is the diagnosis and treatment of lymphoma.

Data availability statement

The data that support the findings of this study are available from the corresponding authors, Song Y. and Wu M., upon reasonable request.

ORCID

Mingzi Yang http://orcid.org/0000-0003-4011-235X

Weiping Liu http://orcid.org/0000-0002-0367-1411

Additional information

Funding

This work was supported by the National Natural Science Foundation of China [grant numbers 81470368 and 81670187]; Beijing Natural Science Foundation [grant number 7172047]; Capital's Funds for Health Improvement and Research [grant number 2018-1-2151]; Beijing Municipal Administration of Hospitals’ Ascent Plan [grant number DFL20151001]; and Beijing Medical and Health Foundation [grant number 2221-16-157].