Originally published as JCO Early Release 10.1200/JCO.2007.11.8869 on December 17 2007

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Lymphocyte-Predominant and Classical Hodgkin's Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group

Lucia Nogová, Thorsten Reineke, Corinne Brillant, Michal Sieniawski, Thomas Rüdiger, Andreas Josting, Henning Bredenfeld, Roman Skripnitchenko, Rolf-Peter Müller, Hans-Konrad Müller-Hermelink, Volker Diehl, Andreas Engert

From the Clinic I for Internal Medicine of University Hospital Cologne, Cologne; Department of Pathology, University Wuerzburg, Wuerzburg; Clinic of Radiotherapy, University Hospital Cologne; and the German Hodgkin Study Group, Cologne, Germany

Corresponding author: Lucia Nogová, MD, First Department of Internal Medicine, University Hospital Cologne, Kerpenerstr 62, 50924 Cologne, Germany; e-mail: lucia.nogova{at}uk-koeln.de

Purpose Lymphocyte-predominant Hodgkin's lymphoma (LPHL) is rare and differs in histologic and clinical presentation from classical Hodgkin's lymphoma (cHL). To shed more light on the prognosis and outcome of LPHL, we reviewed all LPHL patients registered in the German Hodgkin Study Group (GHSG) database, comparing patient characteristics and treatment outcome with cHL patients.

Patients and Methods We analyzed retrospectively 8,298 HL patients treated within the GHSG trials HD4 to HD12, of whom 394 had LPHL and 7,904 had cHL.

Results Complete remission and unconfirmed complete remission after first-line treatment was achieved in 91.6% v 85.9% of patients in early favorable stages, 85.7% v 83.3% of patients in early unfavorable stages, and 76.8% v 77.8% of patients in advanced stages of LPHL compared with cHL, respectively. Tumor control (freedom from treatment failure [FFTF]) for LPHL and cHL patients at a median observation of 50 months was 88% and 82% (P = .0093) and overall survival (OS) was 96% and 92%, respectively (P = .0166). In LPHL patients, negative prognostic factors were advanced stage (P = .0092), Hb less than 10.5 g/dL (P = .0171), and lymphopenia (P = .010) for FFTF. Age 45 years (P = .0125), advanced stage (P = .0153), and Hb less than 10.5 g/dL (P = .0014) were negative prognostic factors for OS.

Conclusion The better prognosis of LPHL as compared with cHL might allow different treatment strategies, particularly for early-stage LPHL patients.

published online ahead of print at www.jco.org on December 17, 2007.

Supported by the Deutsche Krebshilfe (German Cancer Aid), the German Federal Ministry of Education and Research (BMBF), and the Kompetenznetz Maligne Lymphome (Competence Network Malignant Lymphoma).

Presented in part at the Hodgkin Lymphoma Simultaneous Session at the 48th American Society of Hematology Annual Meeting, December 9-12, 2006, Orlando, FL.

L.N. and T.R. contributed equally to this article.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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