Pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma.
10.3760/cma.j.cn112152-20210302-00190
- Author:
Xue Min XUE
1
;
Zheng CAO
1
;
Ting YUAN
1
;
Yi Yang LUO
1
;
Jia Li MU
1
;
Yan QIN
2
;
Xiao Li FENG
1
Author Information
1. Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
2. Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
- Publication Type:Journal Article
- Keywords:
Classic Hodgkin′s lymphoma;
Nodular sclerosis grade 2;
Prognosis
- MeSH:
Adult;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Bleomycin/therapeutic use*;
Cyclophosphamide/therapeutic use*;
Dacarbazine/therapeutic use*;
Doxorubicin/therapeutic use*;
Etoposide/therapeutic use*;
Hodgkin Disease/drug therapy*;
Humans;
Necrosis/drug therapy*;
Prednisone/therapeutic use*;
Prognosis;
Retrospective Studies;
Sclerosis/drug therapy*;
Vinblastine/therapeutic use*;
Vincristine/therapeutic use*
- From:
Chinese Journal of Oncology
2022;44(6):581-586
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the pathological characteristics and clinical prognosis of nodular sclerosis grade 2 of classic Hodgkin's lymphoma (cHL-NS2) in our cancer center. Methods: A retrospective collection of 23 cases of cHL-NS2 admitted in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from July 2008 to April 2019 was performed. Fifty-five cases of nodular sclerosis grade 1 of classical Hodgkin's lymphoma (cHL-NS1) during the same period were selected as control group. Survival curves were plotted using the Kaplan-Meier method, and Cox regression model was used to analyze the influencing factors for survival. Results: The median age of 23 cases of cHL-NS2 was 30 years old. Five cases had extra nodal invasion, and 19 cases were Ⅰ-Ⅱ stage based on Ann Arbor system. The pathological morphology of cHL-NS2 showed that the lymph node structure was completely destroyed and was divided into nodules by thick collagen. The tumor cells in the nodules were abundant and proliferated in sheets. The boundaries between the tumor cells were not clear. The incidence of tumor necrosis in cHL-NS2 was 43.5% (10/23), which was significantly higher than 18.2% (10/55) in cHL-NS1 (P=0.040). The 3-year progression-free survival (PFS) rate of patients in the cHL-NS2 group was 58.1%, which was significantly lower than 89.7% in the cHL-NS1 group (P=0.002). In all of 78 cases, the 3-year PFS rate of patients who did not obtain complete response (CR) was 67.1%, which was significantly lower than 92.2% in patients who achieved CR (P=0.030). Multivariate Cox regression analysis demonstrated that both cHL-NS2 and failure to obtain CR by first-line treatment were independent indicators for short PFS time (P<0.05). Conclusions: In cHL-NS2, the morphology of tumor cells are diverse, and tumor necrosis can be easily found. Under the current first-line treatments of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) or bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), cHL-NS2 is an independent indicator for worse PFS.
