A simplified scoring system to document variant patterns in nodular lymphocyte predominant Hodgkin lymphoma

Abstract

This study sought to quantify variant patterns in nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) using a three tier scoring system assessing five parameters, namely: (a) percentage of nodularity scored from 100 % to < 75%, (b) T cell rich areas (< 20% to > 50%), (c) type of nodules, (d) dendritic network, intact or lost, and (e) extranodular distribution of lymphocyte predominant cells (< 15% to > 50%), with final scores from 0 to 10. In the 72 patients assessed, the 5-year disease-free survival (DFS) in patients with score ≤ 6 was 92% vs. 20% in those with scores > 6. The 5-year overall survival was 100% in patients with scores ≤ 6 and 87% in those with scores > 6. In the multivariate Cox regression analysis, scores > 6 and stage impacted DFS. This scoring system was effective in stratifying patients with NLPHL with variant patterns and could be used for the management of patients.

Keywords::

• Nodular lymphocyte predominant Hodgkin lymphoma
• histology
• disease outcome
• variant pattern
• scoring

Acknowledgements

The authors thank Suhas Dhende and Manjudevi Gupta for their help with immunohistochemistry and Mrs. Sadhana Kannan, Statistician, ACTREC, for the statistical analyses. Funding for this study constitutes a part of Intramural TERRY FOX foundation funding for a project on Toll receptors in NLPHL.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.