Treatment outcomes of Hodgkin lymphoma in the Czech Republic.
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BACKGROUND: The aim of this analysis was to assess the efficacy of treatment and its impact on prognosis of patients with Hodgkin's lymphoma (HL) enrolled in the Czech HL Registry. PATIENTS AND METHODS: Overall 2,241 patients with classical HL (cHL) and 130 patients with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) treated between 2000 and 2024 were analyzed. Median age at diagnosis was 37 years in cHL and 42 years in NLPHL. RESULTS: The most common chemotherapy regimen in early and intermediate stages was ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) in combination with radiotherapy (RT). Moreover, two cycles of escalated BEACOPP (bleomycin, etoposide doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) combined with two cycles of ABVD and RT were used in patients aged < 60 years in intermediate stages. The most common therapy in advanced stages was escalated BEACOPP (4-8 cycles) in patients aged < 60 years and ABVD (6-8 cycles) in patients aged ≥ 60 years. Patients with NLPHL were treated with RT alone or with combination of rituximab and chemotherapy or with a combination of RT based on clinical stages. The 10-year progression-free survival (PFS) and overall survival (OS) in patients with cHL aged < 60 years were: in early stages 91.5% and 94.2%, in intermediate stages 91.0% and 96.6% and in advanced stages 83.9% and 92.6%, respectively. The 10-year PFS and OS in cHL ≥ 60 years were: in early stages 67.0% and 74.2%, in intermediate stages 36.4% and 45.7%, in advanced stages 41.6% and 52.0%, respectively. The 10-year PFS and OS in NLPHL patients were 77.5% and 95.8%. CONCLUSION: Based on the data from the Czech HL Registry, the prognosis of HL patients aged < 60 years is excellent: the 10-year OS is achieved in more than 90% of cases. Median OS of patients aged ≥ 60 years is 10 years. Implementation of checkpoint inhibitors or brentuximab vedotin into the first-line treatment will further improve its efficacy and reduce the toxicity.