Abstract P109

Are refractory/relapsed Hodgkin lymphoma patients can be recognized earlier?

Introduction: Hodgkin lymphoma (HL) is highly curable malignant disease, 10-30% of the patients are relapsed or refractory (R/R) to the first-line treatment. Early diagnosis and effective treatment of these patients are essential for the subsequent recovery.

Patients and Methods: HL patients (<60 years) who were treated in our department between 01.01.2010 and 2023.03.30 were examined using a retrospective method. We compared the clinical characteristics and laboratory parameters of R/R HL patients with patients remaining in complete remission (CR). We also analyzed these datas in terms of therapeutic changes and survival.

Results: All in all 171 patients (82 women and 89 men) datas were processed. The median age was 32 (17-59). According to histological subtype, nodular sclerosis was dominant (56%). About 90% of the patients received ABVD treatment as first-line therapy. Among the patients, 38 were in the R/R group (17 women and 21 men), and 133 were in the CR group (65 women and 68 men). In our R/R group, 81% of the patients received only chemotherapy (CT), and 16% received chemoradiotherapy (CRT). Among our patients in CR, 67% received CT, and 32% received CRT. There is no significant difference between the groups in treatment. We examined the prognostic role of the laboratory results which were taken at the time of the diagnosis and after two complete cycles of treatment. Prognostic value was found in the platelet/monocyte ratio, LDH/hemoglobin ratio, and the combination of the two ratios. At the time of staging, the platelet/monocyte ratio (> 987.5) and LDH/hemoglobin ratio (>3.22) are unfavorably influenced survival. We created a risk classification from these parameters (low risk: 0 points, high risk: 1-2 points), due to this score the 5-year OS was 95% vs. 82% (p<0.001), and the 5-year PFS was 84.4% vs. 64.3% (p=0.001). We also compared the results of interim PET/CT scan. There were significantly more PET positive (Deauville score 4-5)t patients in the R/R group P=0.043).

Conclusion: Independently, clinical characteristics do not help in the early identification of R/R patients. We would like to use further biomarker studies (e.g: ctDNA, TARC) combined with the interim PET/CT result to represent a significant advancement.