Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin's disease and lymphocyte-rich classical Hodgkin's disease: Report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin's disease
Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin's disease and lymphocyte-rich classical Hodgkin's disease: Report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin's disease
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DOI：
10.1200/jco.1999.17.3.776
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发表时间：
1999-03-01
影响因子：
45.3
通讯作者：
Stein, H
中科院分区：
文献类型：
--
作者：
Diehl, V;Sextro, M;Stein, H
目的：最近的研究表明，淋巴细胞为主型霍奇金病（LPHD）在临床和病理学上均不同于其他形式的霍奇金病，包括经典型霍奇金病（CHD），然而，大规模临床研究正在进行中，这项多中心、回顾性研究调查了根据形态学和形态学分类的LPHD患者和富含淋巴细胞的经典型霍奇金病（LRCHD）患者的临床特征和病程。免疫表型标准、材料和方法：从欧洲和美国17个中心收集所有最初提交为LPHD的病例的临床数据和活检材料，由病理专家染色和重新分类。结果：426例可评估病例被重新分类为LPHD（51%）、LRCHD（27%）、CHD（5%）、非霍奇金淋巴瘤（3%）和反应性病变(3%)； 11% 的案例无法评估。 LPHD 和 LRCHD 患者主要为男性，疾病处于早期阶段，危险因素很少。 LRCHD 患者年龄明显较大，LPHD 和 LRCHD 患者在充分治疗后的生存率和无失败生存率相似，且具有分期依赖性，但并不明显优于 CHD 的分期可比结果（德国试验数据）。 27% 的复发性 LPHD 患者出现多次复发，显着高于 5% 的复发性 LRCHD 患者出现多次复发。与 LRCHD 或 CHD 患者相比，淋巴细胞为主型霍奇金病患者复发后的生存率显着提高；然而，这部分是由于 LPHD 患者的平均年龄较年轻。结论：LPHD 和 LRCHD 的两个亚组具有与 CHD 不同的密切临床相似性；该病程与可比较的结节性硬化症和混合细胞性患者的病程相似，必须进行彻底的分期以检测 LPHD 和 LRCHD 患者的晚期疾病。如何治疗此类患者的问题，无论是通过降低治疗强度还是遵循“观察和等待”的方法，仍然没有答案，(C) 1999，美国临床肿瘤学会。
Purpose: Recent studies have suggested that lymphocyte-predominant Hodgkin's disease (LPHD) is both clinically and pathologically distinct from or her forms of Hodgkin's disease, including classical Hodgkin's disease (CHD), However, large-scale clinical studies were tacking, This multicenter, retrospective study investigated the clinical characteristics and course of LPHD patients and lymphocyte-rich classical Hodgkin's disease (LRCHD) patients classified according to morphologic and immunophenotypic criteria,Materials and Methods: Clinical data and biopsy material of all available cases initially submitted as LPHD were collected from 17 European and American centers, stained, and reclassified by expert pathologists.Results: The 426 assessable cases were reclassified as LPHD (51%), LRCHD (27%), CHD (5%), non-Hodgkin's lymphoma (3%), and reactive lesion (3%); 11% of cases were not assessable. Patients with LPHD and LRCHD were predominantly male, with early-stage disease and few risk factors. Patients with LRCHD were significantly older, Survival and failure-free survival rates with adequate therapy were similar for patients with LPHD and LRCHD, and were stage-dependent and not significantly better than stage-comparable results for CHD (German trial data), Twenty seven percent of relapsing LPHD patients had multiple relapses, which is significantly more than the 5% of relapsing LRCHD patients who had multiple relapses. Lymphocyte-predominant Hodgkin's disease patients herd significantly superior survival after relapse compared with LRCHD or CHD patients; however, this was partly due to the younger average age of LPHD patients,Conclusion: The two subgroups of LPHD and LRCHD bore a close clinical resemblance that was distinct from CHD; the course was similar to that of comparable nodular sclerosis and mixed cellularity patients, Thorough staging is necessary to detect advanced disease in LPHD and LRCHD patients. The question of how to treat such patients, either by reducing treatment intensity or following a "watch and wait" approach, remains unanswered, (C) 1999 by American Society of Clinical Oncology.