Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for cla...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-04-01
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| Series: | HemaSphere |
| Online Access: | http://journals.lww.com/10.1097/HS9.0000000000000837 |
| _version_ | 1797226736271753216 |
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| author | Manuel Gotti Roberta Sciarra Alessandro Pulsoni Francesco Merli Stefano Luminari Caterina Zerbi Livio Trentin Alessandro Re Chiara Rusconi Simonetta Viviani Andrea Rossi Federica Cocito Barbara Botto Erika Meli Antonello Pinto Irene Dogliotti Guido Gini Benedetta Puccini Francesca Ricci Luca Nassi Alberto Fabbri Anna Marina Liberati Michele Merli Andrea Riccardo Filippi Maurizio Bonfichi Valentina Zoboli Germana Tartaglia Giorgia Annechini Gianna Maria D’Elia Ilaria Del Giudice Isabel Alvarez Andrea Visentin Stefano Pravato Daniela Dalceggio Chiara Pagani Silvia Ferrari Caterina Cristinelli Tanja Lazic Virginia Valeria Ferretti Umberto Ricardi Luca Arcaini |
| author_facet | Manuel Gotti Roberta Sciarra Alessandro Pulsoni Francesco Merli Stefano Luminari Caterina Zerbi Livio Trentin Alessandro Re Chiara Rusconi Simonetta Viviani Andrea Rossi Federica Cocito Barbara Botto Erika Meli Antonello Pinto Irene Dogliotti Guido Gini Benedetta Puccini Francesca Ricci Luca Nassi Alberto Fabbri Anna Marina Liberati Michele Merli Andrea Riccardo Filippi Maurizio Bonfichi Valentina Zoboli Germana Tartaglia Giorgia Annechini Gianna Maria D’Elia Ilaria Del Giudice Isabel Alvarez Andrea Visentin Stefano Pravato Daniela Dalceggio Chiara Pagani Silvia Ferrari Caterina Cristinelli Tanja Lazic Virginia Valeria Ferretti Umberto Ricardi Luca Arcaini |
| author_sort | Manuel Gotti |
| collection | DOAJ |
| description | Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL. |
| first_indexed | 2024-04-24T14:29:39Z |
| format | Article |
| id | doaj.art-09f7bb15b7604be5994072aa44cd7825 |
| institution | Directory Open Access Journal |
| issn | 2572-9241 |
| language | English |
| last_indexed | 2024-04-24T14:29:39Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | HemaSphere |
| spelling | doaj.art-09f7bb15b7604be5994072aa44cd78252024-04-03T03:31:55ZengWileyHemaSphere2572-92412023-04-0174e83710.1097/HS9.0000000000000837202304000-00015Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana LinfomiManuel Gotti0Roberta Sciarra1Alessandro Pulsoni2Francesco Merli3Stefano Luminari4Caterina Zerbi5Livio Trentin6Alessandro Re7Chiara Rusconi8Simonetta Viviani9Andrea Rossi10Federica Cocito11Barbara Botto12Erika Meli13Antonello Pinto14Irene Dogliotti15Guido Gini16Benedetta Puccini17Francesca Ricci18Luca Nassi19Alberto Fabbri20Anna Marina Liberati21Michele Merli22Andrea Riccardo Filippi23Maurizio Bonfichi24Valentina Zoboli25Germana Tartaglia26Giorgia Annechini27Gianna Maria D’Elia28Ilaria Del Giudice29Isabel Alvarez30Andrea Visentin31Stefano Pravato32Daniela Dalceggio33Chiara Pagani34Silvia Ferrari35Caterina Cristinelli36Tanja Lazic37Virginia Valeria Ferretti38Umberto Ricardi39Luca Arcaini401 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy1 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy3 Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy4 Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy4 Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy2 Department of Molecular Medicine, University of Pavia, Italy6 Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy7 Division of Hematology, Spedali Civili, Brescia, Italy8 Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy8 Division of Hematology and Blood Marrow Transplantation, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy9 Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy10 Division of Hematology, ASST Monza, Ospedale S. Gerardo, Monza, Italy11 Division of Hematology, Azienda Ospedale Città della Salute e della Scienza, Torino, Italy12 Division of Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy13 Hematology-Oncology and Stem-Cell Transplantation Unit, Department of Hematology and Developmental Therapeutics, Istituto Nazionale Tumori, Fondazione G. Pascale, IRCCS, Napoli, Italy14 Division of Hematology, Department of Molecular Biotechnologies and Health Sciences, University of Torino, Italy15 Department of Hematology, Ospedali Riuniti, Ancona, Italy16 Division of Hematology, Ospedale Careggi, Firenze, Italy17 Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano, Milano, Italy18 Hematology, Department of Translational Medicine, AOU Maggiore della Carità and University of Eastern Piedmont, Novara, Italy19 Division of Hematology, Azienda Ospedaliero- Universitaria Senese, Siena, Italy20 Division of Hematology, Azienda Ospedalaliera S. Maria di terni – Università degli Studi di Perugia, Italy21 Division of Hematology, Ospedale di Circolo e Fondazione Macchi, Varese, Italy22 Radiation Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy1 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy1 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy3 Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy3 Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy3 Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy3 Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Italy4 Division of Hematology, Azienda USL-IRCCS of Reggio Emilia, Italy6 Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy6 Hematology Unit, Department of Medicine - DIMED, University of Padova, Italy7 Division of Hematology, Spedali Civili, Brescia, Italy7 Division of Hematology, Spedali Civili, Brescia, Italy9 Hematology and Bone Marrow Transplant Unit, ASST Papa Giovanni XXIII, Bergamo, Italy2 Department of Molecular Medicine, University of Pavia, Italy2 Department of Molecular Medicine, University of Pavia, Italy24 Service of Clinical Epidemiology and Biometry, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy25 Radiation Oncology, Department of Oncology, University of Turin, Italy1 Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, ItalyNodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare entity whose neoplastic cells retain a B-cell phenotype with expression of CD20. Radiotherapy is recommended for favorable stage IA disease while for other stages guidelines suggest therapeutic strategies similar to those used for classic HL. The role of rituximab, although quite widespread, is not completely elucidated. We retrospectively analyzed baseline characteristics of 308 consecutive patients with NLPHL diagnosed in 19 Italian centers from 2000 to 2018. With a median follow-up of 8.4 years (interquartile range: 4.5–12.4) for treated patients, median overall survival (OS) was not reached and estimated 5-year OS was 97.8% and 5-year progression-free survival (PFS) was 84.5%. Five-year cumulative incidence of histological transformation was 1.4%, 95% confidence interval (CI), 0.5%-3.8%. After adjusting for lymphocyte count, splenic involvement, bulky disease and B symptoms (fever, drenching night sweats, unintentional loss >10% of body weight within the preceding 6 months), patients with stage II or more showed superior PFS with immunochemotherapy in comparison to chemotherapy alone (hazard ratio = 0.4, 95% CI, 0.2-0.8; P = 0.015). Our data suggest an advantage of the use of rituximab combined with chemotherapy ± radiotherapy in the treatment of stage II–III–IV NLPHL.http://journals.lww.com/10.1097/HS9.0000000000000837 |
| spellingShingle | Manuel Gotti Roberta Sciarra Alessandro Pulsoni Francesco Merli Stefano Luminari Caterina Zerbi Livio Trentin Alessandro Re Chiara Rusconi Simonetta Viviani Andrea Rossi Federica Cocito Barbara Botto Erika Meli Antonello Pinto Irene Dogliotti Guido Gini Benedetta Puccini Francesca Ricci Luca Nassi Alberto Fabbri Anna Marina Liberati Michele Merli Andrea Riccardo Filippi Maurizio Bonfichi Valentina Zoboli Germana Tartaglia Giorgia Annechini Gianna Maria D’Elia Ilaria Del Giudice Isabel Alvarez Andrea Visentin Stefano Pravato Daniela Dalceggio Chiara Pagani Silvia Ferrari Caterina Cristinelli Tanja Lazic Virginia Valeria Ferretti Umberto Ricardi Luca Arcaini Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi HemaSphere |
| title | Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi |
| title_full | Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi |
| title_fullStr | Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi |
| title_full_unstemmed | Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi |
| title_short | Role of Rituximab Addition to First-line Chemotherapy Regimens in Nodular Lymphocyte-predominant Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi |
| title_sort | role of rituximab addition to first line chemotherapy regimens in nodular lymphocyte predominant hodgkin lymphoma a study by fondazione italiana linfomi |
| url | http://journals.lww.com/10.1097/HS9.0000000000000837 |
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