Materiały źródłowe

• #1 Hodgkin Lymphoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK499969/

  Hodgkin lymphoma generally has an excellent prognosis, though this depends on several factors. […] Hodgkin lymphoma has an excellent overall prognosis with approximately an 80% cure rate. […] Prognosis depends on several prognostic factors, including disease stage. Disease stage is currently only one factor in the prognostic indices used for pretreatment risk stratification and assessment. The 5-year overall survival (OS) in stage 1 or 2a is approximately 90%; on the other hand, stage 4 disease has a 5-year OS of approximately 60%. […] Prognosis depends on several prognostic factors, including disease stage. Disease stage is currently only one factor in the prognostic indices used for pretreatment risk stratification and assessment. The 5-year overall survival (OS) in stage 1 or 2a is approximately 90%; on the other hand, stage 4 disease has a 5-year OS of approximately 60%.

• #2 Hodgkin lymphoma prognosis | Blood Cancer UK

  https://bloodcancer.org.uk/understanding-blood-cancer/lymphoma/hodgkin-lymphoma/prognosis/

  In general, the long-term prognosis (whats likely to happen in the future) is very good for people with Hodgkin lymphoma. For most people, treatment leads to a cure, even if they are diagnosed at an advanced stage. […] In general, the earlier Hodgkin lymphoma is diagnosed the better the prognosis. But its important to know that even if you have advanced stage Hodgkin lymphoma when you are diagnosed, there is still a good chance treatment will be successful and you will be cured. […] If you have unfavourable Hodgkin lymphoma you may need slightly more treatment, but it is still highly curable. […] Stage 1 survival rates: 9 in 10 people (90%) diagnosed at stage 1 survive for at least 5 years. Stage 2 survival rates: Around 9 in 10 people (90%) diagnosed at stage 2 survive for at least 5 years. Stage 3 survival rates: Around 8 in 10 people (around 80%) diagnosed at stage 3 survive for at least 5 years. Stage 4 survival rates: More than 7 in 10 people (more than 70%) diagnosed at stage 4 survive for at least 5 years.

• #3 Survival statistics for Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/prognosis-and-survival/survival-statistics

  Survival statistics for Hodgkin lymphoma (HL) are very general estimates and must be interpreted very carefully. These statistics only tell you about outcomes for groups of people. They cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for Hodgkin lymphoma is 85%. This means that, on average, about 85% of people diagnosed with Hodgkin lymphoma will survive for at least 5 years. […] Generally, the earlier HL is diagnosed and treated, the better the outcome. […] Overall, HL is very responsive to treatment. […] The International Prognostic Score (IPS) for advanced disease (stages 3 and 4) is based on 7 unfavourable (adverse) risk factors that are present at the time of diagnosis. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #4 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  Hodgkin lymphoma may be treated with chemotherapy, radiation therapy, and stem-cell transplantation. The choice of treatment often depends on how advanced the cancer has become and whether or not it has favorable features. If the disease is detected early, a cure is often possible. In the United States, 88% of people diagnosed with Hodgkin lymphoma survive for five years or longer. For those under the age of 20, rates of survival are 97%. […] Treatment of Hodgkin lymphoma has been improving. Types of chemotherapy have resulted in higher survival rates than have previously been seen. In a 2007 European trial, the five-year survival rate for those people with a favorable prognosis (FFP) was 98%, while that for people with worse outlooks was at least 85%. […] The adverse prognostic factors identified in the international study are: Age 45 years, Stage IV disease, Hemoglobin 10.5 g/dl, Lymphocyte count 600/L or 8%, Male, Albumin 4.0 g/dl, White blood count 15,000/L.

• #5 Predicting treatment outcome in classical Hodgkin lymphoma: genomic advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3129642/

  Classical Hodgkin lymphoma is considered a highly curable disease; however, 20% of patients cannot be cured with standard first-line chemotherapy and have a dismal outcome. […] Current clinical parameters do not allow accurate risk stratification, and personalized therapies are lacking. […] In fact, Hodgkin lymphoma (HL) is often over- or undertreated because of this lack of accurate risk stratification. […] In recent years, the early detection of chemoresistance by fluorodeoxyglucose positron emission tomography has become the most important prognostic tool in the management of HL. […] However, to date, no prognostic scores or molecular markers are available for the early identification of patients at very high risk of failure of induction therapy. […] The treatment decision algorithm for cHL is based on clinical parameters: the Ann Arbor staging system is the main staging system used and allows distinction between early-stage and advanced-stage disease.

• #6 Predicting treatment outcome in classical Hodgkin lymphoma: genomic advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3129642/

  This very simplified risk stratification determines the lack of differentiated and personalized treatment options in clinical practice. […] For this reason, HL is often over- or undertreated. […] About half of all patients who have disease relapse after first-line chemotherapy have their disease successfully treated with high-dose chemotherapy followed by autologous stem cell transplantation. […] In recent years, fluorodeoxyglucose (FDG) positron emission tomography (PET) (FDG-PET) has significantly changed the management of HL: it is now the basis for the initial staging and risk-adapted therapy approach. […] In fact, early-interim FDG-PET (a PET scan performed after two cycles of ABVD chemotherapy) has emerged as the most important prognostic tool in HL. […] This review summarizes the prognostic tools and biomarkers that are available for characterizing newly diagnosed HL, and highlights recent advances in genomic studies of cHL and their implications for predicting treatment outcome and for identifying potential targets for therapy.

• #7 Prognosis and survival for Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/prognosis-and-survival

  If you have Hodgkin lymphoma (HL), you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many risk factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] The stage of HL is an important factor in determining a prognosis and planning treatment. But how far the HL has spread and the organs or areas of tissue it affects can be different within each stage. So doctors use the following factors to help them estimate a prognosis for early and advanced HL. These factors are called unfavourable (adverse) risks because they mean there is a greater risk that the HL will come back (relapse) after it is treated.

• #8 Prognosis and survival for Hodgkin lymphoma | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/hodgkin-lymphoma/prognosis-and-survival

  The International Prognostic Score (IPS) helps doctors predict a prognosis and determine treatment for people with advanced HL. It is based on the following 7 unfavourable risk factors. […] Stage 4 HL has a less favourable prognosis than stage 2B or stage 3. […] People who are 45 or older have a less favourable prognosis. […] Men have a less favourable prognosis than women. […] A hemoglobin level of less than 105 g/L is less favourable. […] An albumin level of less than 40 g/L is less favourable. […] A white blood cell count of 15,000/mm 3 or more is less favourable. […] A lymphocyte count of less than 600/mm 3 or less than 8% of the total white blood cell count is less favourable. […] Survival statistics for Hodgkin lymphoma (HL) vary with each stage. Overall HL is very responsive to treatment.

• #9 Pediatric Hodgkin lymphoma– biomarkers, drugs, and clinical trials for translational science and medicine | Oncotarget

  https://www.oncotarget.com/article/11509/text/

  The Childhood Hodgkin Lymphoma International Prognostic Score (CHIPS) system described four clinical factors that are predictive of worse event-free survival (EFS): stage IV disease, large mediastinal adenopathy, albumin level 3.5 g/dL, and fever. […] Most pediatric HL patients are cured with current first line risk-adapted and response-based chemotherapy. […] Despite the high overall cure rates for HL patients, patients with early relapse or inadequate response are unlikely to achieve long-term remission with standard salvage therapy, and their prognosis remains grim. […] The primary long-term complication of HL treatment is the development of secondary malignancy, which remains a cause for concern, especially for pediatric HL patients.

• #10 LLS | Lymphoma Survival Rate By Age

  https://lls.org/blog/lymphoma-diagnosis-survival-rate-age-prognosis-and-treatment

  Hodgkin lymphoma has some of the most encouraging survival rates among cancers. The 5-year survival rate for Hodgkin lymphoma is about 89%, but it varies depending on age. The lymphoma survival by age trends show that younger people generally have better outcomes than older adults. […] For example: Teens and young adults (ages 15-40) often have a 5-year survival rate of over 90%. This age group is generally able to better tolerate intensive treatments like chemotherapy and radiation. Older adults (ages 55+) tend to have lower lymphoma survival rates by age, around 65%, as their overall health and ability to undergo aggressive treatments may be limited. […] Advancements in medicine have improved the lymphoma prognosis by age, giving people of all ages better chances of successful treatment.

• #11 Circulating Biomarkers in Hodgkin Lymphoma | SpringerLink

  https://link.springer.com/10.1007/978-94-007-7744-6_5-1

  Although the long-term disease control of classical Hodgkin lymphoma (cHL) is relatively high, significant treatment-related morbidities are common. […] Accurate risk stratification is needed in order to optimally treat cHL. […] Existing clinical parameters have limited prognostic value prior to therapy, and the only established marker of value once treatment has commenced is 18-fluorodeoxyglucose positron emission tomography (FDG-PET) combined with computerized tomography (CT). […] Furthermore, PET/CT is unavailable in many rural or underprivileged centers and, even in the most advantaged centers, is impractical for frequent testing. […] In order to risk-stratify patients once therapy has commenced, clinicians need an accurate marker of treatment response that can be performed throughout the therapy, prior to each follow-up visit. […] This chapter focuses on two newly identified serum disease response biomarkers, CD163 and TARC, for cHL that have the potential to greatly assist clinical decision making and aid interpretation of PET/CT.

• #12 Hodgkin lymphoma – Wikipedia

  https://en.wikipedia.org/wiki/Hodgkin_lymphoma

  The use of positron emission tomography (PET) early after commencing chemotherapy has demonstrated to have powerful prognostic ability. This enables assessment of an individual’s response to chemotherapy as the PET activity switches off rapidly in people who are responding. […] The evidence is uncertain about the effect of negative (= good prognosis) or positive (= bad prognosis) interim PET scan results for people with a Hodgkin lymphoma on the progression-free survival. Negative interim PET scan results may result in an increase in progression-free survival compared if the adjusted result was measured. Negative interim PET scan results probably result in a large increase in the overall survival compared to those with a positive interim PET scan result.

• #13 Predicting treatment outcome in classical Hodgkin lymphoma: genomic advances

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3129642/

  A subset of patients has disease that is refractory to primary standard chemotherapy (primary refractory disease), and these patients have dismal outcomes following all subsequent treatments. […] Even with high-dose chemotherapy followed by autologous stem cell transplantation, only a minority of patients with primary refractory disease can be cured. […] This group of patients can be well defined regarding their treatment outcomes; however, no prognostic score or diagnostic tools are available for the early identification of patients at very-high risk for failure of induction therapy. […] Studies that have assessed FDG-PET as a prognostic tool used during chemotherapy have reported that it is useful for predicting poor outcomes and building a risk-adapted therapy approach in HL. […] Remarkably, in that study interim PET was more predictive of outcome than the IPS score. […] Elevated pretreatment levels of TARC production have been correlated with adverse outcomes in patients with HL, and permanently high TARC levels after treatment are related to shorter PFS and OS.

• #14 Meta-analysis of the prognostic and clinical value of tumor-associated macrophages in adult classical Hodgkin lymphoma | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0711-6

  Classical Hodgkin lymphoma (cHL) carries an excellent prognosis for most patients, with more than 80 % of patients experiencing long-term remission following conventional chemotherapy or radiotherapy-based protocols. […] The objective of this study was to evaluate the prognostic significance of elevated density of CD68+ and CD163+ TAMs in the tumor microenvironment on overall survival (OS) and PFS in patients with adult cHL. […] Our results demonstrated that a high density of either CD68+ or CD163+ TAMs in the tumor microenvironment significantly predicted poor OS and shorter PFS for adult cHL. […] The results of our meta-analysis indicate an association between increased density of both CD68+ and CD163+ TAMs in the tumor microenvironment of adult cHL and poor outcome. […] In conclusion, the results presented here indicate that a high density of either CD68+ or CD163+ TAMs in the tumor microenvironment of adult cHL is associated with poor survival.

• #15 Meta-analysis of the prognostic and clinical value of tumor-associated macrophages in adult classical Hodgkin lymphoma | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0711-6

  The prognostic significance of tumor-associated macrophages (TAM) in adult classical Hodgkin lymphoma (cHL) remains controversial. Here, we report a meta-analysis of the association of CD68 and CD163 infiltration on the clinical outcome of adult cHL. […] Our analysis indicated that a high density of CD68+ TAMs in the tumor microenvironment of adult cHL predicted poor overall survival (OS) (HR: 2.41; 95 % CI, 1.923.03), shorter progression-free survival (PFS) (HR: 1.78; 95 % CI, 1.452.18), and poor disease-specific survival (HR: 2.71; 95 % CI, 1.385.29). High density of CD163+ TAMs in the tumor microenvironment of adult cHL also predicted poor OS (HR: 2.75; 95 % CI, 1.584.78) and poor PFS (HR: 1.66; 95 % CI, 1.222.27). […] Our analyses suggest that a high density of either CD68+ or CD163+ TAMs is a robust predictor of adverse outcomes in adult cHL.

• #16 Prognostic value of baseline metabolic tumour volume in advanced-stage Hodgkin’s lymphoma | Scientific Reports

  https://www.nature.com/articles/s41598-021-02734-w

  Our aim was to evaluate the prognostic value of initial total metabolic tumour volume (TMTV) in a population of patients with advanced-stage Hodgkins lymphoma (HL). […] Considering all the treatments and using a threshold of 217 cm3, TMTV was predictive of 5-year PFS and PET response after two courses of chemotherapy. […] In multivariable analysis involving TMTV, IPI score, and the first treatment received, TMTV remained a baseline prognostic factor for 5-year PFS. […] Baseline TMTV appears to be a useful independent prognostic factor for predicting relapse in advanced-stage HL in ABVD subgroup, with a tendency of survival curves separation in BEACOPP subgroup. […] A high TMTV allows the identification of patients with high risk for HL recurrence in the whole population. […] The results of multivariable analysis involving TMTV, IPI score, and the first treatment received showed that TMTV remains a baseline prognostic factor for 5-year PFS, in contrast with IPI score.

• #17 Prognostic value of baseline metabolic tumour volume in advanced-stage Hodgkin’s lymphoma | Scientific Reports

  https://www.nature.com/articles/s41598-021-02734-w

  In the population of patients treated with BEACOPP, optimal cut-off was higher (331 cm3) compared to ABVD subgroup (217 cm3). […] The prognostic value of TMTV is now well known in diffuse large B-cell lymphoma, peripheral T-cell lymphoma, and early stage HL, but remains poorly studied in advanced HL. […] Our study highlights the prognostic value of TMTV in advanced HL, which could enable the definition of new groups of patients according to their risk of recurrence. […] Baseline TMTV appears to be a useful independent prognostic factor for predicting relapse in advanced stage HL in the ABVD subgroup, with a tendency of survival curves separation in BEACOPP subgroup and could be used to improve risk stratification.

• #18 New Prognostic Biomarker for Hodgkin Lymphoma Identified Using AI – Pathology News

  https://www.pathologynews.com/computational-pathology-ai/new-prognostic-biomarker-for-hodgkin-lymphoma-identified-using-ai/

  In a recent study, researchers at Justus Liebig University and Heidelberg University used deep learning to quantify a potential new biomarker — the amount of weakly stained collagen fibers in biopsies — and correlated this with patient outcomes. Their aim was to evaluate whether AI-aided image analysis could enable accurate quantification of histological features predictive of prognosis in Hodgkin lymphoma. […] The study showed that quantification of collagen fibers using picrosirius red could discriminate cases based on the risk of progression and that the percentage of weakly stained fibers was significantly associated with treatment response. […] „Our results suggest that patients with poor treatment response may have more aberrant fibers with weak staining and irregular consistency compared to patients with good response,” said Dr. Ila Motmaen, the first author of the study.

• #19 New Prognostic Biomarker for Hodgkin Lymphoma Identified Using AI – Pathology News

  https://www.pathologynews.com/computational-pathology-ai/new-prognostic-biomarker-for-hodgkin-lymphoma-identified-using-ai/

  He cautioned, however, that the prognostic power of aberrant fibers is not powerful enough to be used as a sole biomarker. […] Currently, there are no reliable biomarkers to identify high-risk patients early during treatment. […] More aggressive therapy or experimental regimens could be administered to patients at risk of recurrence, whereas low-risk patients could be spared the unnecessary toxicity of intensive regimens. […] The study revealed a significant association between higher percentages of weakly stained collagen fibers and worse post-chemotherapy qPET scores, indicating a higher risk of recurrence after treatment (P = 0.0185). […] Collectively, these results suggest that the degree of weak collagen fiber staining could be a quantitative biomarker for predicting the prognosis of Hodgkin lymphoma. However, the relationship between the percentage of weakly stained collagen fibers and prognosis was not strong enough for clinical use. […] „While promising, the prognostic value of quantified weakly stained fibers was not strong enough for high confidence prognosis,” Dr. Motmaen noted. The prognostic value of collagen fibers in Hodgkin Lymphoma warrants further validation in larger patient cohorts.

• #20 Long-term survival after treatment for Hodgkin’s disease (1973–2002): improved survival with successive 10-year cohorts | British Journal of Cancer

  https://www.nature.com/articles/bjc2012228

  Overall, patients were observed for 9.8 (0.334.82) years (median(range)), on average. One, five and fifteen-year disease-specific survival was found to be 87% (8590%), 77% (7480%) and 70% (6774%), respectively. For those for diagnosed between 1973 and 1982, the 15-year survival was found to be 57%; for 19831992, it was 74% and for 19932002, it was 83% (P0.001). The difference remained significant after adjusting for prognostic factors. Treatment advances and effective management of toxicities of treatment over time, have resulted in a significantly longer survival for patients with Hodgkins disease diagnosed within a defined population. […] The cure rate for HD in Nottinghamshire has improved significantly over a 30-year period with patients treated in the most recent cohort, (19932002) having a cure rate of 75% (15 year cause specific survival). This compares with a cure rate of 52% in the era 19731982. Our results suggest a clear improvement in survival time was observed. After adjusting for other factors, regarding time to death, a 4-fold deceleration was found for the latest cohort compared with the earliest (95% CI 2.39.3). […] The improvement in survival seen in the three consecutive cohorts in our series is independent of all of these prognostic factors.

• #21 Staging & Prognosis for Hodgkin Lymphoma | Cancer Council NSW

  https://www.cancercouncil.com.au/hodgkin-lymphoma/diagnosis/staging-and-prognosis/

  Staging is a way of describing how far Hodgkin lymphoma has spread throughout the body. […] Prognosis means the expected outcome of a disease. You may wish to discuss your prognosis and treatment options with your haematologist (or medical oncologist if they are your main treating specialist). It is not possible for anyone to predict the exact course of the disease in an individual person. Instead, your doctor can give you an idea about the common issues that affect people with your type of Hodgkin lymphoma. […] Hodgkin lymphoma usually responds well to treatment, and most people who are treated for Hodgkin lymphoma (including advanced disease) go into remission. This means the symptoms of Hodgkin lymphoma disappear and the doctor can’t find any sign of the disease during a physical examination or on imaging tests. […] In a small number of cases, Hodgkin lymphoma may not respond to the initial treatment, which is known as refractory disease, or it may come back (relapse or recur) after remission.

• #22 Pediatric Hodgkin lymphoma– biomarkers, drugs, and clinical trials for translational science and medicine | Oncotarget

  https://www.oncotarget.com/article/11509/text/

  Hodgkin lymphoma (HL) is a lymphoid malignancy that is typically derived from germinal-center B cells. […] Although current risk adapted and response based treatment approaches yield overall survival rates of 95%, treatment of relapse or refractory patients remains challenging. […] The risk of developing secondary leukemia following childhood HL treatment is 10.4 to 174.8 times greater than the risk in the general pediatric population and the prognosis is significantly poorer than the other hematological malignancies with a mortality rate of nearly 100%. […] Here we discuss epidemiology, risk factors, staging, molecular and genetic prognostic biomarkers, treatment for low and high-risk patients, and the late occurrence of secondary malignancies in pediatric HL. […] However, the prognosis of relapse/refractory (RR) patients is dismal.

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