The Impact of Complex Treatment, Doxorubicin C27H29NO11, Bleomycin C55H84N17O21S3, Vinblastine C46H58N4O9 and Dacarbazine C6H10N6O Correlated with Haematological Parameters on Hodgkin�s Lymphoma Survival Prognostic

Monica Pescaru,Cristina Potre-Oncu,Adina - Ioana Bucur,Stela Iurciuc,Hortensia Ionita,Bogdan Niculescu,Virgil Radu Enatescu,Madalina Veronica Boruga,Ovidiu Potre-Oncu

doi:10.37358/rc.20.7.8270

Abstract

Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin�s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients� survival, on the other hand. Patients� response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C46H58N4O9, dacarbazine C6H10N6O) and radiation therapy. Response to treatment was also influenced by eosinophil levels at diagnosis and this has effects on survival. Finally, lymphocyte and platelet levels at diagnosis correlated with survival times in our study group. Therefore, eosinophil, lymphocyte and platelet levels at diagnosis could be considered as prognostic factors for HL, although further studies are needed to validate our findings.

Highlights

Hodgkin’s lymphoma (HL) is among the most treatable malignancies, over 80% of the patients undergoing a therapy regimen being cured; left untreated, 90% of patients will die in up to 3 years [1]
Identification of risk factors is critical for providing tailored treatment strategies, while both clinical and biological parameters were utilized as prognostic factors for HL and are widely included in the prognostic scores to discriminate between risk groups [3]
European Organization for Research and Treatment of Cancer (EORTC) /Lymphoma Study Association and German Hodgkin Study Group (GHSG) have defined three risk groups based on similar prognostic factors [4]. Both groups consider large mediastinal masses and elevated erythrocyte sedimentation rate (ESR) among the risk factors. While both groups define the involvement of nodal areas as a negative prognostic factor, different cut-points are considered by EORTC (≥4 nodal areas) and GHSG (≥3 nodal areas)

Summary

Introduction

Hodgkin’s lymphoma (HL) is among the most treatable malignancies, over 80% of the patients undergoing a therapy regimen being cured; left untreated, 90% of patients will die in up to 3 years [1]. European Organization for Research and Treatment of Cancer (EORTC) /Lymphoma Study Association and German Hodgkin Study Group (GHSG) have defined three risk groups (limited, intermediate and advanced stages) based on similar prognostic factors [4]. Both groups consider large mediastinal masses and elevated erythrocyte sedimentation rate (ESR) among the risk factors. Each of the two groups have described additional risk factors, namely age ≥50 years (EORTC) and extranodal disease (GHSG) These prognostic scores are used by both groups to assign patients to a treatment type, which is adjusted according to the risk group

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Conclusion