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High-risk stage IIB Hodgkin lymphoma treated in the H10 and AHL2011 trials: total metabolic tumor volume is a useful risk factor to stratify patients at baseline

Authors :
Cédric Rossi
Marc André
Jehan Dupuis
Franck Morschhauser
Bertrand Joly
Julien Lazarovici
Hervé Ghesquières
Aspasia Stamatoullas
Emmanuelle Nicolas-Virelizier
Pierre Feugier
Anne-Claire Gac
Hannah Moatti
Luc-Matthieu Fornecker
Bénédicte Deau
Clémentine Joubert
Catherine Fortpied
John Raemaekers
Massimo Federico
Salim Kanoun
Michel Meignan
Alexandra Traverse-Glehen
Anne-Ségolène Cottereau
René-Olivier Casasnova
Source :
Haematologica, Vol 107, Iss 12 (2022)
Publication Year :
2022
Publisher :
Ferrata Storti Foundation, 2022.

Abstract

Stage IIB Hodgkin lymphoma (HL) patients, with a mediastinum-to-thorax (M/T) ratio of ≥0.33 or extranodal localization have a poor prognosis and are treated either as limited or advanced stage. We compared these two approaches in patients included in two randomized phase III trials enrolling previously untreated early (H10) or advanced stage HL (AHL2011). We included HL patients with Ann-Arbor stage IIB with M/T ≥0.33 or extranodal involvement enrolled in the H10 or AHL2011 trials with available positron emission tomography at baseline (PET0) and after two cycles of chemotherapy (PET2). Baseline total metabolic tumor volume (TMTV) was calculated using the 41% SUVmax method. PET2 response assessment used the Deauville score. One hundred and fourty-eight patients were eligible, including 83 enrolled in the AHL2011 trial and 65 in the H10 trial. The median TMTV value was 155.5 mL (range, 8.3-782.9 mL), 165.6 mL in AHL2011 and 147 mL in H10. PET2 positivity rates were 16.9% (n=14) and 9.2% (n=6) in AHL2011 and H10 patients, respectively. With a median follow-up of 4.1 years (95% confidence interval [CI]: 3.9-4.4), overall 4-year PFS was 88.0%, 87.0% in AHL2011 and 89.2% in H10. In univariate and mutivariate analyses, baseline TMTV and PET2 response influenced significantly progression-free survival (hazard ratio [HR]=4.94, HR=3.49 respectively). Notably, among the 16 patients who relapsed, 13 (81%) had a baseline TMTV baseline ≥155 mL. Upfront ABVD plus radiation therapy or upfront escBEACOPP without radiotherapy provide similar patient’s outcome in high-risk stage IIB HL. TMTV is useful to stratify these patients at baseline.

Details

Language :
English
ISSN :
03906078 and 15928721
Volume :
107
Issue :
12
Database :
Directory of Open Access Journals
Journal :
Haematologica
Publication Type :
Academic Journal
Accession number :
edsdoj.3bfa108c1d994483b55ceb83af3e2524
Document Type :
article
Full Text :
https://doi.org/10.3324/haematol.2021.280004