scholarly journals Hodgkin lymphoma detection and survival: findings from the Haematological Malignancy Research Network

BJGP Open ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. bjgpopen19X101668 ◽  
Author(s):  
Maxine JE Lamb ◽  
Eve Roman ◽  
Debra A Howell ◽  
Eleanor Kane ◽  
Timothy Bagguley ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Advanced Disease ◽  
Prognostic Score ◽  
Stage Iv ◽  
Relative Survival ◽  
Emergency Admission ◽  
Signs And Symptoms ◽  
Population Based ◽  
Research Network ◽  
The Relationship

BackgroundHodgkin lymphoma is usually detected in primary care with early signs and symptoms, and is highly treatable with standardised chemotherapy. However, late presentation is associated with poorer outcomes.AimTo investigate the relationship between markers of advanced disease, emergency admission, and survival following a diagnosis of classical Hodgkin lymphoma (CHL).Design & settingThe study was set within a sociodemographically representative UK population-based patient cohort of ~4 million, within which all patients were tracked through their care pathways, and linked to national data obtained from Hospital Episode Statistics (HES) and deaths.MethodAll 971 patients with CHL newly diagnosed between 1 September 2004–31 August 2015 were followed until 18th December 2018.ResultsThe median diagnostic age was 41.5 years (range 0–96 years), 55.2% of the patients were male, 31.2% had stage IV disease, 43.0% had a moderate–high or high risk prognostic score, and 18.7% were admitted via the emergency route prior to diagnosis. The relationship between age and emergency admission was U-shaped: more likely in patients aged <25 years and ≥70 years. Compared to patients admitted via other routes, those presenting as an emergency had more advanced disease and poorer 3-year survival (relative survival 68.4% [95% confidence interval {CI} = 60.3 to 75.2] versus 89.8% [95% CI = 87.0 to 92.0], respectively [P<0.01]). However, after adjusting for clinically important prognostic factors, no difference in survival remained.ConclusionThese findings suggest that CHL survival as a whole could be increased by around 4% if the cancer in patients who presented as an emergency had been detected at the same point as in other patients.

Progress in Hodgkin lymphoma: a population-based study on patients diagnosed in Sweden from 1973-2009

Blood ◽  
2012 ◽  
Vol 119 (4) ◽  
pp. 990-996 ◽  
Author(s):  
Jan Sjöberg ◽  
Cat Halthur ◽  
Sigurdur Y. Kristinsson ◽  
Ola Landgren ◽  
Ulla Axdorph Nygell ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Age Groups ◽  
Relative Survival ◽  
Population Based ◽  
Term Treatment ◽  
Cure Rate ◽  
Population Based Study ◽  
Long Term Treatment

Abstract In recent decades, attention has focused on reducing long-term, treatment-related morbidity and mortality in Hodgkin lymphoma (HL). In the present study, we looked for trends in relative survival for all patients diagnosed with HL in Sweden from 1973-2009 (N = 6949; 3985 men and 2964 women; median age, 45 years) and followed up for death until the end of 2010. Patients were categorized into 6 age groups and 5 calendar periods (1973-1979, 1980-1986, 1987-1994, 1994-2000, and 2001-2009). Relative survival improved in all age groups, with the greatest improvement in patients 51-65 years of age (P < .0005). A plateau in relative survival was observed in patients below 65 years of age during the last calendar period, suggesting a reduced long-term, treatment-related mortality. The 10-year relative survival for patients diagnosed in 2000-2009 was 0.95, 0.96, 0.93, 0.80, and 0.44 for the age groups 0-18, 19-35, 36-50, 51-65, and 66-80, respectively. Therefore, despite progress, age at diagnosis remains an important prognostic factor (P < .0005). Advances in therapy for patients with limited and advanced-stage HL have contributed to an increasing cure rate. In addition, our findings support that long-term mortality of HL therapy has decreased. Elderly HL patients still do poorly, and targeted treatment options associated with fewer side effects will advance the clinical HL field.

scholarly journals Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study

2021 ◽  
Vol 11 (12) ◽  
Author(s):  
Ilja Kalashnikov ◽  
Tomas Tanskanen ◽  
Janne Pitkäniemi ◽  
Nea Malila ◽  
Sirkku Jyrkkiö ◽  
...  
Keyword(s):  
B Cell ◽  
Hodgkin Lymphoma ◽  
Relative Survival ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Population Based Study ◽  
Entire Study ◽  
Risk Of Death ◽  
Increased Risk ◽  
Histological Transformation

AbstractNodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare B-cell malignancy associated with excellent survival. However, some patients experience histological transformation into aggressive large B-cell lymphoma. Population-based data on transformation in patients with NLPHL is limited. We conducted a nationwide population-based study to estimate the risk of transformation and relative survival in patients diagnosed with NLPHL in Finland between 1995 and 2018. We identified a total of 453 patients (median age, 48 years; 76% males) with the incident NLPHL from the Finnish Cancer Registry. The cumulative incidence of transformation was 6.3% (95% CI, 4.2-9.6) at 10 years. After adjusting for sex, age and year of diagnosis, transformation was associated with a substantially increased risk of death (HR 8.55, 95% CI 4.49−16.3). Ten-year relative survival was 94% (95% CI, 89%‒100%). The patients diagnosed at a later calendar year had lower excess risk of death (HR, 0.38 per 10-year increase; 95% CI, 0.15‒0.98). We conclude that while the 10-year relative survival for the patients with NLPHL was excellent in this large population-based cohort for the entire study period, transformation resulted in a substantially increased mortality compared with the patients without transformation. Our results also suggest a reduction in excess mortality over time.

scholarly journals Relative Survival of Patients with Nodal Marginal Zone Lymphoma in the United States: A Population-Based Analysis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 5-6
Author(s):  
John L Vaughn ◽  
Laura C Pinheiro ◽  
Narendranath Epperla
Keyword(s):  
United States ◽  
Excess Mortality ◽  
Marginal Zone ◽  
Advanced Disease ◽  
Relative Survival ◽  
Population Level ◽  
The United States ◽  
Population Based ◽  
Stage At Diagnosis ◽  
Nodal Marginal Zone Lymphoma

Introduction: Nodal marginal zone lymphoma (NMZL) is an indolent B-cell non-Hodgkin lymphoma (iNHL) that usually presents in elderly patients with painless lymphadenopathy. Patients often have advanced disease at diagnosis, and bone marrow involvement is common. Treatment of NZML involves radiation therapy for localized disease, and systemic therapy for advanced disease including single-agent rituximab, rituximab and chemotherapy (such as bendamustine, chlorambucil), or novel agents (especially in the relapsed setting such as ibrutinib, lenalidomide and PI3K inhibitors). The objective of this study was to determine whether advances in treatment and supportive care over the past decade have translated to improved relative survival at the population level in patients with NMZL in the United States. Method: We used the population-based Surveillance, Epidemiology, and End Results (SEER)-18 database. We included adult patients with NMZL diagnosed between 2000-2017 who were 18-84 years old at the time of diagnosis. We excluded patients with a history of malignancy prior to NMZL, those with missing survival times and those with central nervous system involvement. Patients were divided into two cohorts based on period of diagnosis (era-1: 2000-2008, and era-2: 2009-2017). Relative survival (RS) was estimated using the Pohar-Perme method, and the difference between RS distributions was tested using a log-rank-type test. Relative survival was modeled using Poisson regression where the effect of follow-up time was included as restricted cubic spline with 5 knots. All tests of differences were performed at a two-sided alpha of 0.05. Results: We included 5,355 patients with NMZL. Table 1 shows the baseline characteristics. The median age at diagnosis was 66 years (IQR = 56-74 years). Most patients were non-Hispanic White (73%) with advanced stage at diagnosis (stage III-IV, 63%). The 5-year RS (unadjusted) was 84% (95% CI = 82% - 86%) for patients diagnosed in era-1 and 86% (95% CI = 84% - 89%) for patients diagnosed in era-2 (log-rank-type p = 0.07). Figure 1A shows cumulative RS, and Figure 1B shows the trend in 5-year RS over the study period (including model-based and empirical estimates). In our multivariable Poisson regression model for RS, the period of diagnosis, age, sex, median household income, and stage at diagnosis were significant predictors of excess mortality (Table 2). Patients in era-2 had significantly lower excess mortality [excess hazard ratio (EHR) = 0.76, 95% CI=0.62-0.93], while excess mortality significantly increased with age over 65 years [EHR = 2.09, 95% CI=1.70-2.56], male sex [EHR = 1.38, 95% CI=1.13-1.68], and advanced stage at diagnosis [EHR = 1.96, 95% CI=1.47-2.63]. Conclusion: There has been a significant improvement in RS in the most recent era for patients with NMZL in the United States after adjusting for differences in age, sex, race/ethnicity, income, and stage at diagnosis. This improvement at the population level is likely reflective of the improvement in supportive care and advances in the NMZL treatment including identification of better tolerable chemotherapy regimens and novel agents. Disclosures Epperla: Verastem Oncology: Speakers Bureau; Pharmacyclics: Honoraria.

scholarly journals Comparing Survival After Recurrent vs De Novo Stage IV Advanced Breast, Lung, and Colorectal Cancer

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Michael J Hassett ◽  
Hajime Uno ◽  
Angel M Cronin ◽  
Nikki M Carroll ◽  
Mark C Hornbrook ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
De Novo ◽  
Clinical Trial Design ◽  
Stage Iv ◽  
Population Based ◽  
Advanced Breast ◽  
Research Network ◽  
Matched Pairs ◽  
Advanced Cancer Patients ◽  
Significant Difference

Abstract The treatments provided to and survival of patients with recurrent vs de novo stage IV advanced breast, lung, and colorectal cancer may differ but have not been well studied. Using population-based data from the Cancer Research Network for 4510 patients with advanced breast, lung, or colorectal cancer, we matched recurrent/de novo patients on demographic factors. We found longer survival for recurrent vs de novo lung cancer (182 matched pairs); no significant difference for colorectal cancer (332 matched pairs); and shorter survival for recurrent vs de novo breast cancer (219 matched pairs). Compared with recurrent cases, chemotherapy use and radiation therapy use were more common among de novo cases. Differences in treatment and survival between recurrent and de novo advanced cancer patients could inform prognostic estimates and clinical trial design.

scholarly journals Prognostic Factors Associated with Lung Cancer Survival: A Population-Based Study in Southern Spain

2019 ◽  
pp. 1-10
Author(s):  
Isabel Linares ◽  
José Expósito ◽  
Elena Molina-Portillo ◽  
Yoe-Ling Chang ◽  
Juan Pedro Arrebola ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Survival ◽  
Performance Status ◽  
Treatment Options ◽  
Survival Rates ◽  
Primary Lung Cancer ◽  
Stage Iv ◽  
Relative Survival ◽  
Population Based ◽  
Stage I

Purpose: Lung cancer is the leading cause of cancer death worldwide. The objective was to analyze survival for lung cancer in Granada, and to identify the factors influencing survival. Methods: Data were obtained from the population-based cancer registry in Granada (Spain). All cases of newly diagnosed primary lung cancer in 2011-2012 (n=685) were included. One and two-year relative survival was estimated. Results: Of our population, 65% of the patients were over 65 years of age, and 83% were men. 74% of patients had good performance status (PS); 81% of the tumors were microscopically verified; and 81% were non-small cell lung cancer. Overall, 16% were stage I-II, whereas 57% were stage IV. Radiotherapy was administered in 28% of cases, chemotherapy in 45%, whereas 23% of patients were operated. The two-year survival rate was 18% (67% and 5% for stage I and IV). Survival was higher among women (29%), <75 years of age (21.6%), and those with good PS (23%). Microscopic verification and surgery led to higher survival rates of 23.4% and 69%, respectively. Conclusions: Since the factors affecting survival were PS, stage, and surgery, efforts should target the early diagnosis of lung cancer since this would improve treatment options and outcomes.

Rapid desensitization to brentuximab vedotin after severe anaphylaxis in the treatment of refractory Hodgkin’s lymphoma

2020 ◽  
pp. 107815522094229
Author(s):  
Rosalaura V. Villarreal-Gonzalez ◽  
Sandra N. Gonzalez-Diaz ◽  
Cindy E. de Lira-Quezada ◽  
David Gómez-Almaguer ◽  
Andres Gómez-De León ◽  
...  
Keyword(s):  
Total Dose ◽  
Hodgkin Lymphoma ◽  
Stage Iv ◽  
Signs And Symptoms ◽  
Brentuximab Vedotin ◽  
Hypersensitivity Reactions ◽  
Antibody Drug Conjugate ◽  
Severe Anaphylaxis ◽  
12 Steps ◽  
Desensitization Protocol

Introduction Brentuximab vedotin is a monoclonal antibody drug conjugate used for the treatment of patients with Hodgkin lymphoma. Hypersensitivity reactions to brentuximab vedotin may include cutaneous, cardiovascular, respiratory, gastrointestinal and neurological signs and symptoms. Case report We present the case of a 23-year-old Mexican female with stage IV progressive classical nodular sclerosing Hodgkin lymphoma who received multiple previous chemotherapy regimens. Brentuximab vedotin at 1.8 mg/kg (180 mg total dose), for 21-day cycles was indicated. Within 5 min of infusion of the 5th cycle of brentuximab, she developed severe anaphylaxis (hives, angioedema, diaphoresis, tachycardia, dyspnea, hypoxemia and loss of consciousness), which was successfully controlled with epinephrine, steroids and antihistamines. Management and outcome: Intradermal skin test at a concentration of 0.1 mg/ml was positive. Due to the severity of the symptoms and the lack of access to alternative treatments, we performed a desensitization protocol. A total of 180 mg of brentuximab was given in three bag solutions in 12 steps, with an initial concentration dose of 1/100 of the total dose in a course of 5.56 h with no hypersensitivity reactions. Discussion Severe anaphylaxis has been reported in 1.2% of patients receiving brentuximab vedotin. Patients who are treated by rapid drug desensitization with their first option therapy present a favorable survival rate with better cost-effectiveness in comparison to second-line treatment.

Sign in / Sign up

Export Citation Format

Share Document