Clinical features and outcomes of newly diagnosed classical Hodgkin lymphoma patients in Saudi Arabia: a multicenter cohort study.
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Classical Hodgkin Lymphoma (cHL) is a prominent B-cell neoplasm, that impacts global and Saudi populations. Given limited large-scale studies focusing on HL in Saudi Arabia, this retrospective multicenter cohort study reviewed the characteristics and clinical outcomes of patients with cHL in Saudi Arabia. All adult patients aged 18 years and older newly diagnosed with cHL at three local tertiary care hospitals were included between January 2016 and December 2021. The primary outcome was to identify the patient's clinical features such as histopathology, risk category, disease stage, and favorable and unfavorable risk factors. Other outcomes include the complete response (CR) assessment post the initial chemotherapy, complications post-chemotherapy, time from cHL initial diagnosis to either refractoriness or relapse disease, progression-free survival (PFS), and overall survival (OS) rate, which were considered secondary. Out of 765 screened patients, 498 patients with cHL were included. The cohort had a median age of 30 years. Histopathological analysis revealed that the majority of the patients had nodular sclerosis (80.7%) and were classified as stage IV (44.8%). The predominant chemotherapy regimen administered was ABVD, utilized in 84.9%. The overall response rate was 90.4%, with 85.2% achieving complete remission. After a median follow-up duration of 3.5 years, the OS was 94.9%, and the PFS was 82.1%. Among patients with relapsed or refractory disease, 56 underwent hematopoietic stem cell transplantation as a part of second-line therapy. The overall response rate post-second-line was 80%. Notably, patients who underwent transplantation had a significantly longer median OS compared to those who did not (49.3 vs. 42.8 months; p = 0.04). However, no significant difference in PFS was observed (9.8 vs. 9.4 months; p = 0.32). This national study offers insights into the clinical features and outcomes of cHL patients in Saudi Arabia, demonstrating that ABVD chemotherapy achieves a high overall response rate and complete remission, with favorable survival rates after a median follow-up of 3.5 years. Furthermore, hematopoietic stem cell transplantation improves median overall survival for patients with relapsed or refractory disease, underscoring the need for close monitoring to manage side effects and enhance outcomes.