Comparative efficacy of the R-BEACOPP-14 and R-CHOP regimens in the treatment of patients with advanced stages of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) with THRLBCL-like histopathological growth patterns in the tumor biopsy
Our data demonstrated an unfavorable prognostic value of THRLBCL-like histopathological growth patterns in the tumor substrate. Differentiated approaches of the therapy of this patients group have not been defined yet.
to evaluate the results of 1st line therapy of advanced stages NLPHL patients with THRLBCL-like histopathological growth patterns in the tumor biopsy, depending on the type of induction chemotherapy program.
Materials and methods:
Results of 1st line therapy in 150 patients with NLHLP observed from 2010 to 2021 were analyzed. Growth patterns without THRLBCL-like sites was observed in 87/150 (58%) patients, of them 33 (38%) had advanced stages of the disease (AS). THRLBCL-like patterns were in 63/150 (42%), of them 55 (87%) pts with AS. Patterns with predominance of THRLBCL-like areas (more than 50% of the cut area) - 32 (21%), of them 31 (97%) pts with AS.
In 33/87(38%) pts with growth patterns without THRLBCL-like areas – chemotherapy was performed in 27/33(81%) pts: R-BEACORP-14 in 17/27(63%), R-ABVD in 10/27(37%), all pts achieved complete remission (CR).
In of 55/63(87%) pts with advanced stages and with THRLBCL-like patterns, chemotherapy was underwent in 54/55(98%) pts: R-BEACORP-14 - 30/54(56%), of them CR - 18/ 30(60%); R-CHOP - 12/54 (21%), of them CR - 4/12 (30%); other - 12/54 (23%) pts.
In 31/32(97%) pts with advanced stages and with predominance of THRLBCL-like areas, chemotherapy received 30/31(97%) pts: R-BEACORP-14 - 17/30(57%), of them CR - 8/17( 47%); R-CHOP - 8/30 (27%), of them CR - 2/8 (25%); other - 5/30 (17%) pts.
In pts groups with the presence and predominance of THRLBCL-like growth patterns the 5-year OS on the R-BEACOPP-14 scheme was 100% and 62%, and on the R-CHOP - 100% and 69% (p-0.02), respectively. The 3-year EFS on the R-BEACORP-14 scheme was 91% and 44%, and on the R-CHOP - 50% and 29% (p-<0.0001), respectively. Median follow-up is 34 months.
Induction therapy with R-BEACORP-14 allows to achieved the best overall and event-free survival in an unfavorable group of advanced stages NLPHL patients with the presence and predominance of THRLBCL-like growth patterns.