Aims: The European Project HAEMACARE (VI Frame Research Program), is working in the reclassification of hematological neoplasias included in population based Cancer Registries of 13 European countries with the objective to improve and standardize morphological data validation.

Patients and methods: a multidisciplinary research group of the I+CS integrated by epidemiologists, hematologists, pathologists is working in the reclassification of Hodgkin disease (HD) included in the population based Cancer Registry of Zaragoza (CRZ) in order to reclassify according to WHO and ICD-O classifications and identify the non other specification (NOS) cases. From January 1995 to December 2000, a total of 141 patients diagnosed as Hodgkin disease are included. The sources of data were: Zaragoza population based Cancer Registry, Aragon hematological malignancies Registry (FEHHA) and from the records of public Hospitals and the National Deaths Index. All cases were identified from the CRZ and 35 cases (24.8%) NOS were re-studied by the hematologists and pathologists and reclassified according histological and morphological subtypes of WHO classification. Diagnostic criteria were set for LRCHD: scattered Hodgkin-Reed-Sternberg cells with a classical immunophenotype in a background of small lymphocytes without admixture of eosinophils and neutrophils and without sclerosis nodular lymphocyte predominant HD (NLPHD), mixed cellular (MCD) and lymphocyte-rich classical HD (LRCHD). In 24.8% of cases were necessary to process the samples again or review smears and applied immunochemistry techniques in order to establish accurate diagnosis according the new sub-classification in NLPHD or CHD and distinguish some cases of T-cell rich large B-cell lymphoma. In addition we have calculated the estimated survival according specific morphological subtypes.

Results:

Hodgkin Disease. Histological distribution

ICD-0-3No%malesfemalesmean age(y)mean surv(y)No deaths (%)
*non other specification 
NOS* 35 24.8 15 20 43.7 5.8 13 (34.3) 
CHD 64 45.4 39 25 39.3 7.6 19 (29.7) 
MCD 21 14.9 15 6 46.3 7.7 4 (19.0) 
LRCHD 11 7.8 9 2 51.1 6.7 5 (45.5) 
NLPHD 10 7.0 6 4 51.2 8.3 2 (20.0) 
Total 141  84 57 43.2 7.1 43 (30.5) 
ICD-0-3No%malesfemalesmean age(y)mean surv(y)No deaths (%)
*non other specification 
NOS* 35 24.8 15 20 43.7 5.8 13 (34.3) 
CHD 64 45.4 39 25 39.3 7.6 19 (29.7) 
MCD 21 14.9 15 6 46.3 7.7 4 (19.0) 
LRCHD 11 7.8 9 2 51.1 6.7 5 (45.5) 
NLPHD 10 7.0 6 4 51.2 8.3 2 (20.0) 
Total 141  84 57 43.2 7.1 43 (30.5) 
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The estimated survival analysis showed a mean of 7.6 years (95% CI: 6.7–8.4) for all cases, median not reached.

Comments: In our study has been necessary to reclassify the 24.8% of cases according WHO criteria. The incidence peaks are classical. The overall survival is similar to describe previously.

Topics:
cancer, eosinophils, epidemiologists, hematologic neoplasms, hodgkin's disease, hospitals, public, immunochemistry, immunophenotyping, interdisciplinary research, lymphocytes

Acknowlegments: This work is partially supported by HAEMACARE Project (790573).

Author notes

Disclosure: No relevant conflicts of interest to declare.

2007, The American Society of Hematology
2007
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