Background & aim:Although 'interim' positron emission tomography (PET) may inform therapeutic decisions, Risk stratification at diagnosis allows earlier and potentially better modification during treatment of HL. the prognosis of HL in our center.In this study, we aimed to identify the prognostic role of both the IPET and validate Childhood Hodgkin International Prognostic Score (CHIPS) in predicting the prognosis of HL at our hospital.

Patients and methods:This is a retrospective, single-center study where a total of 1140 patients with newly diagnosed Hodgkin lymphoma were enrolled. Only 737 patients were eligible for analysis of both IPET and CHIPS scoring. PET scan was performed at baseline and after two cycles of chemotherapy (ABVD). Treatment was not changed according to the results of the interim scan. Stage 4 disease, large mediastinal mass, albumin (<3.5), and fever were each assigned one point in the CHIPS. Log-rank testing was used to compare EFS for each CHIPS (0-3) secondary analysis to detect EFS in relation to IPET was done.

Results : Only 737 patients were eligible for analysis of both IPET and CHIPS scoring. The 5-year EFS was 95% for patients with CHIPS=0, 94% for patients with CHIPS=1, 84.3% for patients with CHIPS=2, 82.4% for patients with CHIPS=3 and 70% for CHIPS=4 (P-value 0.001).The 5-year OS was 97.4% for patients with CHIPS=0, 97.9% for patients with CHIPS=1, 93.1% for patients with CHIPS=2, 94.7% for patients with CHIPS=3 and 85.6% for CHIPS=4 (P-value 0.039).

Slow early responders as detected by PET have 5-years EFS 73.8%, in comparison, those with evidence of response by PET had 5-year EFS of 91.3 %. Among this better risk patients, CHIPS can further classify patients; EFS 96.4% of patients with CHIPS 0 or 1 versus 85.8% for those with CHIPS 2, 3 or 4 who had an adverse outcome, even in the setting of response by PET (P<0.001).

Conclusion:

CHIPS is a good tool for predicting risk in patients with HL that may help to tailor therapy to risk factors known early at diagnosis. The benefit of using CHIPS versus early response PET scan suggests the feasibility of eliminating the costly PET scans, especially in LMIC.

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Disclosures

No relevant conflicts of interest to declare.

Topics:
bleomycin/dacarbazine/doxorubicin/vinblastine protocol, child, developing countries, hodgkin's disease, positron-emission tomography, pediatrics, albumins, chemotherapy regimen, fever, mediastinal mass

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2019 by The American Society of Hematology
2019
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