Yonsei Med J.  2006 Aug;47(4):455-465. 10.3349/ymj.2006.47.4.455.

Treatment of Hodgkin's Disease: A Twenty-Year Follow-up of Patients at a Center in Korea

• Cheong JW
• Park SY
• Roh JK
• Suh CO
• Hahn JS

• KMID: 1779493
• DOI: http://doi.org/10.3349/ymj.2006.47.4.455

Abstract

Hodgkin's disease (HD) is a hematologic malignancy which shows common features regardless of race, but racial differences may be considered with certain clinical characteritcs. HD in Korea shows somewhat different characteristics when compared to cases in Western countries. We evaluated the clinical and histopathologic characteristics of HD, the outcomes of various chemotherapy regimens, and prognostic factors of HD in Korea. One hundred and five patients with initial histopathologic diagnosis of Hodgkin's disease were retrospectively reviewed 20 years after diagnosis at Yonsei University College of Medicine. Nodular sclerosis was the most common histopathogic subtype (41%) and mixed cellularity was nearly as common (40%). The overall complete remission rate (CR) was 87.6%. The disease-free survival (DFS) and overall survival (OS) rate were 79.2% and 84.8% at 5-years, 70% and 79.2% at 10- and 20-years. There were no significant differences in CR rate and DFS, but OS rates were significantly higher in m-BACOP and ABVD regimen. Univariate analysis revealed that age, B-symptom, ECOG scale, Ann Arbor stage, international prognostic index, and serum beta2-microglobulin level were significant prognostic factors for both DFS and OS. Multivariate analysis demonstrated that age, B symptoms, and ECOG scale were significant prognostic factors for OS only. In conclusion, the survival rates of HD patients in our center were superior to those of previous reports in Korea and Western countries. Considering the higher OS rate and decreased incidence of side effects, the ABVD regimen may be recommended for the initial treatment of Hodgkin's disease.

Keyword

Hodgkin's disease; twenty year survival; chemotherapy; Korea

MeSH Terms

Treatment Outcome
Remission Induction
Prognosis
Middle Aged
Male
Korea
Humans
Hodgkin Disease/mortality/*therapy
Follow-Up Studies
Female
Disease-Free Survival
Child, Preschool
Child
Antineoplastic Agents/*pharmacology
Aged, 80 and over
Aged
Adult
Adolescent

Figure

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  Fig. 1 Disease-free survival rate (A) and overall survival rate (B).

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  Fig. 2 (A) Overall survival rates according to the histological subtypes of the patients; LP, lymphocyte predominance; NS, nodular sclerosis; MC, mixed cellurarity; LD, lymphocyte depletion. (B) Overall survival rates according to the Ann-Arbor stage.

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  Fig. 3 Disease-free survival rates according to the initial treatment modalities in patients with early stage (A), and in patients with advanced stage disease (B). (C) Disease-free survival rates according to the chemotherapy regimens. CTRT, combined chemo-radiotherapy; CT, chemotherapy; RT, radiotherapy; C-MOPP, cyclophosphamide, vincristine, procarbazine, and prednisolone; ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine; COPP-ABV, cyclophosphamide, vincristine, procarbazine, prednisone, doxorubin, bleomycin, and vinblastine; m-BACOP, methotrexate, bleomycin, adriamycin, cyclophosphamide, vincristine, and prednisolone.

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  Fig. 4 Overall survival rates according to the initial treatment modalities in the total population (A), in patients with early stage (B), and in patients with advanced stage disease (C). (D) Overall survival rates according to the chemotherapy regimens. CTRT, combined chemo-radiotherapy; CT, chemotherapy; RT, radiotherapy; C-MOPP, cyclophosphamide, vincristine, procarbazine, and prednisolone; ABVD, doxorubicin, bleomycin, vinblastine, and dacarbazine; COPP-ABV, cyclophosphamide, vincristine, procarbazine, prednisone, doxorubin, bleomycin, and vinblastine; m-BACOP, methotrexate, bleomycin, adriamycin, cyclophosphamide, vincristine, and prednisolone.

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