Radiation Oncology/Hodgkin/Lymphocyte predominant

Hodgkin's Lymphoma: Lymphocyte Predominant

• Lymphocyte-predominant has a different natural history (especially stages I-II) and response to therapy than classical HL.
• Chemo is not indicated in most early stage cases, and standard is IFRT.
• LP has best prognosis of HL subtypes, but late recurrences common and long-term followup necessary.

NCCN Guidelines

• Stage I-IIA: IFRT or regional RT
• Stage I-IIB w/ B sx's: chemotherapy followed by IFRT
• Stage III-IVA: chemotherapy +/- RT –OR— observation (cat 2B) –OR— local RT (palliation only) or rituximab
• Stage III-IVB: chemotherapy +/- RT or rituximab +/- chemo +/- RT

Studies

• Germany, 1999 PMID 10071266 — "Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin's disease and lymphocyte-rich classical Hodgkin's disease: report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin's Disease." Diehl V; J Clin Oncol. 1999 Mar;17(3):776-83.

• GHSG, 2005 PMID 16093276 — "Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG)." Nogova L; Ann Oncol. 2005 Oct;16(10):1683-7.

• GHSG, 2008 PMID 18086799 — "Lymphocyte-predominant and classical Hodgkin's lymphoma: a comprehensive analysis from the German Hodgkin Study Group." Nogova L; J Clin Oncol