Clinicopathological features of classical Hodgkin lymphoma in patients ≥ 40 years old, with special reference to composite cases.

Abstract

OBJECTIVE:

Classical Hodgkin lymphoma shows a peak incidence at 15-35 years, and a second peak in elderly patients; however, pathological characteristics of elderly patients with classical Hodgkin lymphoma have not been analyzed enough.

METHODS:

In a total of 154 patients with classical Hodgkin lymphoma, we analyzed the clinicopathological characteristics of classical Hodgkin lymphoma patients aged ≥ 40 years old, with special reference to the incidence, histopathology and outcome of patients with composite classical Hodgkin lymphoma.

RESULTS:

Of 154 patients with classical Hodgkin lymphoma, 50 (32%) were ≥ 40 years old. The 5-year progression-free and overall survival rates were 59 and 86%, respectively. Thirty-eight patients (76%) had non-composite classical Hodgkin lymphoma, 10 patients (20%) had composite (6 simultaneous and 4 consecutive) classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma and 2 patients (4%) had methotrexate-associated classical Hodgkin lymphoma. Of 10 patients with composite classical Hodgkin lymphoma, composite lymphomas were detected throughout the staging procedure of the upper gastrointestinal tract or bone marrow in 4 patients. Fluorescence in situ hybridization revealed that the composite lymphomas of 4, 1 and 5 patients were related, unrelated and of unknown correlation status, respectively. The treatments after the diagnosis of a classical Hodgkin lymphoma component varied, and three patients died of lymphoma.

CONCLUSIONS:

We found that the incidence of composite classical Hodgkin lymphoma in patients ≥ 40 years old was 20%. Correct diagnosis and optimal treatment for patients with composite classical Hodgkin lymphoma and B-cell non-Hodgkin lymphoma is highly important in this patient population.

• Authors: Akiko Miyagi Maeshima, Hirokazu Taniguchi, Junko Nomoto, Shinichi Makita, Hideaki Kitahara, Suguru Fukuhara, Wataru Munakata, Tatsuya Suzuki, Dai Maruyama, Yukio Kobayashi, Kensei Tobinai
• Journal: Japanese journal of clinical oncology (Jpn J Clin Oncol) Vol. 45 Issue 10 Pg. 921-8 (Oct 2015) ISSN: 1465-3621 [Electronic] England
• PMID: 26206898 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected].

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Female
• Hodgkin Disease (diagnosis, drug therapy, epidemiology, pathology)
• Humans
• In Situ Hybridization, Fluorescence
• Incidence
• Japan (epidemiology)
• Male
• Middle Aged
• Survival Analysis