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ORIGINAL ARTICLE
Year : 2012  |  Volume : 37  |  Issue : 4  |  Page : 234-239

Treatment of early-stage Hodgkin’s lymphoma outcome ( Kuwait experience)


1 Department of Medicine, Ain Shams University, Cairo, Egypt
2 Department of Medical Oncology, Lymphoma & Stem cell Transplantation Unit, Kuwait Cancer Control Center, Kuwait University, Kuwait
3 Department of Caner Statistics & Registry, Kuwait Cancer Control Center, Kuwait

Correspondence Address:
Rehab S. ElHagracy
MD, Kuwait-Al-Jahra, Marzouk Elmetaeb Street, 3rd Floor, Flat 10 P.O. Box 5969, Kuwait

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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJH.0000419279.94780.52

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Introduction

Treatment of early-stage classical Hodgkin’s lymphoma (HL) is changing targeting remission with reduced intensity.

Aim of the work

This study presents a review of treatment of earlystage I and II HL patients treated with adriamycin, bleomycin, vinblastine, dacarbazine (ABVD) with or without radiotherapy.

Materials and methods

Data were analyzed retrospectively from files of patients treated at the Kuwait cancer center from 2002 to 2010. The study included 105 patients divided as follows: group A, which included 34 patients treated by four cycles of ABVD, and group B, which included 71 patients treated by six cycles of ABVD.

Results

Unfavorable risk cases were 47 versus 77.4% in group A versus B. Radiotherapy was added to ABVD in 57.1% of patients; 35.3% of these patients were from group B. No significant difference in remission or relapse was noted between groups A and B (P=0.04). The 5-year overall survival (OS) for patients was 86%, with no difference between the two groups. Patients with B symptoms had significantly lower 5-year OS (73 vs. 92%; P=0.02). Although the presence of bulky disease and erythrocyte sedimentation rate 50 mm/h or more are associated with lower OS, the difference was not significant (P>0.05). Combined therapy yielded better 5-year OS (90.3%) than chemotherapy alone (80.4%), without significance (P=0.29). No cardiopulmonary toxicities or second malignancies were noted but hypothyroidism was evident after neck radiation. This indicates the good outcome of early-stage HL in general. Some prognostic factors could address treatment policy in terms of the presence of B symptoms, bulky disease, and high erythrocyte sedimentation rate.

Conclusion

Modification of therapy on the basis of novel prognostic factors may be of prospective interest.



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