Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study
Abstract Nodular 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 limi...
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| Format: | Article |
| Language: | English |
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Nature Publishing Group
2021-12-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-021-00586-1 |
| _version_ | 1818873662945624064 |
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| author | Ilja Kalashnikov Tomas Tanskanen Janne Pitkäniemi Nea Malila Sirkku Jyrkkiö Sirpa Leppä |
| author_facet | Ilja Kalashnikov Tomas Tanskanen Janne Pitkäniemi Nea Malila Sirkku Jyrkkiö Sirpa Leppä |
| author_sort | Ilja Kalashnikov |
| collection | DOAJ |
| description | Abstract Nodular 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. |
| first_indexed | 2024-12-19T12:58:17Z |
| format | Article |
| id | doaj.art-7cdbd33b83c44b75b830291c76a2b6ec |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-12-19T12:58:17Z |
| publishDate | 2021-12-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-7cdbd33b83c44b75b830291c76a2b6ec2022-12-21T20:20:21ZengNature Publishing GroupBlood Cancer Journal2044-53852021-12-0111121610.1038/s41408-021-00586-1Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based studyIlja Kalashnikov0Tomas Tanskanen1Janne Pitkäniemi2Nea Malila3Sirkku Jyrkkiö4Sirpa Leppä5Research Program Unit, Applied Tumor Genomics, Faculty of Medicine, University of HelsinkiFinnish Cancer Registry, Institute for Statistical and Epidemiological Cancer ResearchFinnish Cancer Registry, Institute for Statistical and Epidemiological Cancer ResearchFinnish Cancer Registry, Institute for Statistical and Epidemiological Cancer ResearchDepartment of Oncology and Radiotherapy, Turku University HospitalResearch Program Unit, Applied Tumor Genomics, Faculty of Medicine, University of HelsinkiAbstract Nodular 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.https://doi.org/10.1038/s41408-021-00586-1 |
| spellingShingle | Ilja Kalashnikov Tomas Tanskanen Janne Pitkäniemi Nea Malila Sirkku Jyrkkiö Sirpa Leppä Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study Blood Cancer Journal |
| title | Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study |
| title_full | Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study |
| title_fullStr | Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study |
| title_full_unstemmed | Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study |
| title_short | Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study |
| title_sort | transformation and outcome of nodular lymphocyte predominant hodgkin lymphoma a finnish nationwide population based study |
| url | https://doi.org/10.1038/s41408-021-00586-1 |
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