Abstract
Objective: To analyze the profile of patients with Hodgkin's Lymphoma refractory to first-line treatment. Methods: This is a cross-sectional, retrospective analytical study with secondary data and a quantitative and descriptive approach, attended at reference hospital in amazonia, with patients with HL who were refractory or relapsed after undergoing first-line treatment. Results: 48 patients with a mean age of 30-39 years, with a time of diagnosis between 2 and 5 years in 68.75%, predominance in the nodular sclerosis subtype of 70.84% were evaluated. B symptoms were present in 91.67% and Bulky disease in 50% at diagnosis. Bone marrow transplantation was performed in 29% of the patients, 12.5% died, remaining patients were in remission or following some type of treatment. Conclusion: HL is a highly curable disease, but refractoriness continues to occur in a number of cases, which can be better managed with access to specific medications and the existence of a transplant center in the state.
References
BRAY F, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin., 2018; 68(6): 394-424.
EICHENAUER DA, et al. Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group. Blood, 2018; 132(14): 1519–1525.
EICHENAUER DA e ENGERT A. How I treat nodular lymphocyte-predominant Hodgkin lymphoma. Blood, 2020; 136(26): 2987-2993.
HERNÁNDEZ-RAMÍREZ RU, et al. Cancer risk in HIV-infected people in the USA from 1996 to 2012: A population-based, registry-linkage study. Lancet HIV, 2017; 4: e495-e504.
HOPPE RT, et al. Hodgkin Lymphoma, Version 2.2020. J Natl Compr Canc Netw., 2020; 18(6): 755-781.
HUANG J, et al. Incidence, mortality, risk factors, and trends for Hodgkin lymphoma: a global data analysis. Journal of Hematology & Oncology, 2022; 15: 57.
HUTCHINGS M, et al. Position emission tomography with or without computed tomography in the primary staging of Hodgkin’s lymphoma. Haematologica, 2006; 91: 482–489.
INSTITUTO NACIONAL DE CÂNCER JOSÉ ALENCAR GOMES DA SILVA (INCA). Estimativa 2020: incidência de câncer no Brasil / Instituto Nacional de Câncer. – Rio de Janeiro: INCA, 2020.
KELLER SP, et al. Late Relapses Following High-Dose Autologous Stem Cell Transplantation (HD-ASCT) for Hodgkin Lymphoma (HL) in the ABVD Therapeutic era. Biol Blood Marrow Transplant, 2012; 18(4): 640-647.
MOHTY R, et al. Latest advances in the management of classical Hodgkin lymphoma: the era of novel therapies. Blood Cancer Journal, 2021; 11: 126.
MOMOTOW J. et al. Hodgkin Lymphoma-Review on Pathogenesis, Diagnosis, Current and Future Treatment Approaches for Adult Patients. J. Clin. Med., 2021; 10: 1125.
MONTEIRO TAF, et al. Linfoma de Hodgkin: aspectos epidemiológicos e subtipos diagnosticados em um hospital de referência no Estado do Pará, Brasil. Rev Pan-Amaz Saude, 2016; 7: 1.
MOTOK A e STEILD C. Biology of classical Hodgkin lymphoma: implications for prognosis and novel therapies. Blood, 2018; 131: 15.
RIBEIRO LA, et al. Linfoma de Hodgkin: Análise de desfechos em óbito no Brasil, na região Norte e no Amapá em uma década. Research, Society and Development, 2021; 10(1).
ROSE A, et al. Classical Hodgkin Lymphoma: Clinicopathologic Features, Prognostic Factors, and Outcomes from a 28-Year Single Institutional Experience. Clin Lymphoma Myeloma Leuk., 2021; 21(2): 132-138.
SHAH GJ e MOSKOWITS CH. Transplant strategies in relapsed/refractory Hodgkin lymphoma. Blood, 2018; 131(15): 1689-1687.
SHANBHAG S e AMBINDER RF. Hodgkin Lymphoma: A Review and Update on Recent Progress. CA CANCER J CLIN., 2018; 68: 116–132.
STRAUS DJ, et al. Brentuximab vedotin with chemotherapy for stage III or IV classical Hodgkin lymphoma (ECHELON-1): 5-year update of an international, open-label, randomised, phase 3 trial. Lancet Haematol, 2021; 8(6): e410-e421.
VASSILAKOPOULOS TP, et al. Optimizing outcomes in relapsed/refractory Hodgkin lymphoma: a review of current and forthcoming therapeutic strategies. Ther Adv Hematol., 2020; 11: 1–31.
WANG H, et al. Diagnosis of Hodgkin lymphoma in the modern era. British Journal of Haematology, 2019; 184: 45–59.
WENIGER MA e KÜPPERS R. Molecular biology of Hodgkin lymphoma. Leukemia, 2021; 35: 968–981.
