Nodular Lymphocytic Predominant Hodgkin Lymphoma (NLPHL); Treatment Outcome Study in a Tertiary Care Cancer Hospital in Pakistan

Nodular Lymphocytic Predo-Minant Hodgkin Lymphoma

Abstract

Objective: To determine the demographics, clinical characteristics and treatment outcomes of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) patients treated at our hospital.

Study Design: Retrospective longitudinal study.

Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan from 1996 to 2016.

Methodology: We collected clinical data of all the cases of HL diagnosed over twenty years (between 1996 and 2016) from our electronic hospital information system (HIS). A total of 3426 HL patients were identified, out of whom the pathologically confirmed diagnosis of nodular lymphocytic predominant Hodgkin lymphoma (NLPHL) was identified.

Results: In this study, eighty-four patients were studied. The majority of the patients were male (80%). B symptoms were present in 35%. There were 24% patients in stage-I (n=20/84), 33% in stage-II (n=28/84), 12% in stage III (n=10/84) and 31% in stage IV (n=26/84). Hence, early-stage was seen in 57% (n=48/84) and advanced stage was 43% (n=36/84) respectively. The Median follows up time was 30 months (range: 1-60 months). Patients were treated with chemotherapy in most cases (48%), radiotherapy alone in 14% cases, and combined modality (chemotherapy and radiotherapy) was used in 38% patients. The estimated 5–year disease-free survival was 73% and overall survival was 86%. Autologous stem cell transplant was done in only one patient whose disease had transformed from NLPHL to T-rich cell B cell lymphoma.

Conclusion: This study confirmed the divergent features of NLPHL with a comparatively good long-term prognosis. Most patients achieved an excellent response to first-line therapy. There was...