Unfavorable Early-Stage Hodgkin Lymphoma: Assessment of Patient Characteristics in a Real-World Setting

Abstract

Aim: Unfavorable prognostic factors among classical Hodgkin lymphoma (cHL) patients in the real-world setting have yet to be fully characterized. Methods: In this retrospective study using the ConcertAI Oncology Dataset, patient characteristics, unfavorable prognostic factors and treatment patterns were evaluated among patients diagnosed with cHL. Results: Among 324 adult cHL patients diagnosed 2016–2021, 16.1% were classified as early favorable, 32.7% early unfavorable and 51.2% advanced disease. Early unfavorable patients were younger and had a larger nodal mass. The prognostic factor B symptoms was most frequently documented in early unfavorable patients (59.4%), followed by bulky disease (46.2%), >3 involved lymph node regions (31.1%), and erythrocyte sedimentation rate ≥50 (25.5%). Conclusion: In this analysis of real-world data, we found that nearly a third of newly diagnosed cHL patients had early unfavorable disease. Our analysis also showed differences in the proportion of patients for each unfavorable factor among patients with early-stage unfavorable cHL.

Plain language summary

Assessment of risk factors in patients with classical Hodgkin lymphoma in a real-world setting What is this article about? Lymphoma is a type of blood cancer that develops when white blood cells grow out of control. This study looked at a certain type of lymphoma called classical Hodgkin lymphoma (cHL). Patients with cHL are put into groups based on risk factors. Risk factors mean the cancer had certain characteristics that make it more likely to spread to other body parts and more difficult to treat. These can be symptoms like drenching night sweats, unexplained fever, sudden weight loss, or large swellings of the infection fighting glands of the body.What did we do? We studied the risk factors of patients with cHL, using data from electronic medical records. What were the results? About a third of the patients in this study had early stage cHL with unfavorable risk factors, and over half of the patients had advanced stage cHL. The patients who had early stage cHL with unfavorable risk factors were younger and had a larger lump in a lymph node. More than half of the patients experienced drenching night sweats, unexplained fever, or weight loss of more than 10%. What do the results mean? We found that nearly a third of new cHL patients had early-stage cHL with unfavorable risk factors. We also showed differences in the number of patients with each unfavorable risk factor among patients with early-stage unfavorable cHL. This study can help doctors and researchers group patients and determine the best treatment or research study for patients who have cHL.

Keywords::

• Hodgkin lymphoma
• real-world data
• retrospective study
• unfavorable factors

Author contributions

S Gautam: Conceptualization, methodology, investigation, writing – review & editing, project administration; S Yeola: Investigation, writing – review & editing, project administration; A Nahar: Writing – review & editing; EM Sarpong: Writing – review & editing; J Prescott: Writing – review & editing; X Yang: Writing – review & editing; HM Sineshaw: Conceptualization, methodology, writing – review & editing, funding acquisition.

Financial & competing interests disclosure

S Gautam and S Yeola report research funding to their institution from Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. EM Sarpong, J Prescott, X Yang and HM Sineshaw are employed by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA and may hold stock or stock options in Merck & Co., Inc., Rahway, NJ, USA. A Nahar was employed by Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA during the conduct of the study. Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA sponsored this study and provided financial support for the conduct of the research and preparation of the article. Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA (the sponsor) collaborated on the design of the study, interpretation of the analyses, and in the decision to submit the article for publication. The sponsor did not have a direct role in data collection, data analysis, or writing of the report. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

G Bishi (ConcertAI) provided programming support for this project, and A Johns (ConcertAI) provided medical writing support for this project. The authors thank N Connors (NCC Medical & Scientific Communications, Inc.) for professional assistance with manuscript preparation, funded by ConcertAI.

Ethical conduct of research

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This research was reviewed and determined to be exempt from Institutional Review Board (IRB) oversight by Advarra IRB (Columbia, Maryland). This research study was conducted retrospectively from data obtained for clinical purposes.

Data sharing statement

ConcertAI does not make datasets publicly available because study data are used under license from source practices and other data providers. ConcertAI will consider requests to access study datasets on a case-by-case basis.