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Lymphoma

Rituximab in newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma: long-term follow-up of a phase 2 study from the German Hodgkin Study Group

Leukemia volume 34, pages 953–956 (2020)Cite this article

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Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a distinct lymphoid malignancy accounting for ∼5% of all Hodgkin lymphoma cases. As the disease-defining lymphocyte predominant cells consistently express CD20, CD20-directed approaches represent a treatment option in this entity [1]. Single-agent anti-CD20 antibody treatment has been evaluated in several phase II studies. Response rates were in excess of 90%. However, disease recurrence was common [2,3,4,5]. This was also true for individuals with newly diagnosed stage IA NLPHL who had received four weekly standard doses (375 mg/m2) of the first-generation anti-CD20 antibody rituximab within a prospective study conducted by the German Hodgkin Study Group (GHSG). At a median observation time of 43 months, relapse had occurred in 7/28 patients (25%) [2]. We herein report a follow-up analysis of this study investigating the long-term course of the individuals treated within the trial protocol. It was also evaluated whether the histopathological growth pattern according to Fan et al. (typical growth pattern, i.e., growth pattern A and B vs. variant histology, i.e., growth pattern C to F) had impact on the patient´s outcome [6]. Previous studies had indicated more advanced disease at diagnosis and an increased relapse rate for patients with a variant histology as compared with patients with a typical growth pattern [7, 8].

Follow-up data from the 28 patients who had been taken into account for the initial analysis of the study were requested from the participating sites. Progression-free survival (PFS) (defined as the time between the completion of the initial staging and NLPHL recurrence or death from any cause and censored at the date of last information on the disease status) and overall survival (OS) (defined as the time between the completion of the initial staging and death from any cause and censored at the date of last information for surviving patients) estimates were calculated using the Kaplan–Meier method. Parameters such as time to relapse and treatment at relapse were evaluated and described. Available biopsies from the initial NLPHL diagnosis were collected and the histopathological growth pattern according to Fan et al. was determined by a panel of expert hematopathologists [6]. Inclusion criteria, endpoints and study treatment have been reported elsewhere [2]. The study was conducted in accordance with the Declaration of Helsinki and was approved by the review boards of the participating sites. It was registered at www.clinicaltrials.gov as #NCT00346684.

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Acknowledgements

The authors gratefully thank the panel of expert hematopathologists for reviewing biopsies from the study participants.

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Authors and Affiliations

  1. First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany

    Dennis A. Eichenauer, Annette Plütschow, Michael Fuchs, Boris Böll, Bastian von Tresckow, Peter Borchmann & Andreas Engert

  2. German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany

    Dennis A. Eichenauer, Annette Plütschow, Michael Fuchs, Boris Böll, Bastian von Tresckow, Peter Borchmann & Andreas Engert

  3. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt, Germany

    Sylvia Hartmann & Martin-Leo Hansmann

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  1. Dennis A. Eichenauer
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Correspondence to Andreas Engert.

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BvT: honoraria from Roche, Takeda and MSD; consulting or advisory role for Amgen, Pfizer, Takeda, MSD; research funding from Novartis, MSD, Takeda; travel funding from MSD, Takeda, Novartis. All other authors declare that they have no conflict of interest.

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Eichenauer, D.A., Plütschow, A., Fuchs, M. et al. Rituximab in newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma: long-term follow-up of a phase 2 study from the German Hodgkin Study Group. Leukemia 34, 953–956 (2020). https://doi.org/10.1038/s41375-019-0609-3

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