Clinical Presentation and Outcomes of Lymphocyte-predominant Hodgkin Disease at the University of Florida

Abstract

To examine the clinical presentation and treatment outcomes of lymphocyte-predominant Hodgkin disease (LPHD) at the University of Florida over a 37-year period. A retrospective review of the clinical presentation and treatment outcomes in 34 patients with LPHD treated at the University of Florida from 1968 to 2005 was conducted. The end points of absolute survival, cause-specific survival, and relapse-free survival were assessed and late treatment sequelae were identified. Ninety-six percent of patients presented with stage I/II disease. None had mediastinal disease, 4 (12%) had bulky disease (>6 cm in maximum tumor dimension), and only 1 (3%) had B symptoms. Eighty percent of patients were treated with radiation therapy (RT) alone and 20% with RT and chemotherapy. At 5, 10, and 15 years, absolute survival was 97%, 85%, and 76%; cause-specific survival was 100%, 95%, and 95%; and relapse-free survival was 93%, 81%, and 74%. No patients died with Hodgkin disease, but 1 patient's death was attributed to treatment-related late sequelae. There were 6 treatment failures, including 2 within the RT field; all failures were successfully salvaged. The median time to relapse was 5.8 years (range, 2.9-14.6 years). Three secondary malignancies were observed. LPHD patients typically present at an early stage without B symptoms, mediastinal, or bulky disease. First-line treatment with RT alone yields excellent results in appropriately selected patients and remains the standard of care. Relapses often occur late and long-term follow-up is needed to successfully diagnose and treat late relapses.