PMID- 26349012
OWN - NLM
STAT- MEDLINE
DCOM- 20160602
LR  - 20160115
IS  - 1096-8652 (Electronic)
IS  - 0361-8609 (Linking)
VI  - 90
IP  - 12
DP  - 2015 Dec
TI  - Long-term survival in young and middle-aged Hodgkin lymphoma patients in Sweden 
      1992-2009-trends in cure proportions by clinical characteristics.
PG  - 1128-34
LID - 10.1002/ajh.24184 [doi]
AB  - Trends in Hodgkin lymphoma (HL) survival among patients treated outside of 
      clinical trials provide real-world benchmark estimates of prognosis and help 
      identify patient subgroups for targeted trials. In a Swedish population-based 
      cohort of 1947 HL patients diagnosed in 1992-2009 at ages 18-59 years, we 
      estimated relative survival (RS), cure proportions (CP), and median survival 
      times using flexible parametric cure models. Overall, the CP was 89% (95% CI: 
      0.87-0.91) and median survival of the uncured was 4.6 years (95% CI: 3.0-6.3). 
      For patients aged 18-50 years diagnosed after the year 2000, CP was high and 
      stable, whereas for patients of 50-59 years, cure was not reached. The survival 
      of relapse-free patients was similar to that of the general population (RS5-year 
      : 0.99; 95% CI: 0.98-0.99, RS15-year : 0.95; 95% CI: 0.92-0.97). The excess 
      mortality of relapsing patients was 19 times (95% CI: 12-31) that of relapse-free 
      patients. Despite modern treatments, patients with adverse prognostic factors 
      (e.g., advanced stage) still had markedly worse outcomes [CP stage: IIIB 0.82 
      (95% CI: 0.73-0.89); CP stage: IVB 0.72, (95% CI: 0.60-0.81)] and patients with 
      international prognostic score (IPS) >/=3 had 2.7 times higher excess mortality 
      (95% CI: 1.0-7.0, p = 0.04) than patients with IPS <3. High-risk patients 
      selected for 6-8 courses of BEACOPP (bleomycin, etoposide, doxorubicin, 
      cyclofosphamide, vincristine, procarbazine, prednisone)-chemotherapy had a 
      15-year relative survival of 87%, (95% CI: 0.80-0.92), whereas the corresponding 
      estimate for patients selected for 6-8 courses of ABVD (doxorubicin, bleomycin, 
      vinblastine, dacarbazine) was 93% (95% CI: 0.88-0.97). These population-based 
      results indicate limited fatal side-effects in the 15-year perspective with 
      contemporary treatments, while the unmet need of effective relapse treatment 
      remains of concern. BEACOPP-chemotherapy was still not sufficient in high-risk HL 
      patients.
CI  - (c) 2015 Wiley Periodicals, Inc.
FAU - Glimelius, Ingrid
AU  - Glimelius I
AD  - Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet and 
      Karolinska University Hospital, Stockholm, Sweden.
AD  - Department of Immunology, Genetics and Pathology Clinical and Experimental 
      Oncology, Uppsala University and Uppsala Akademiska Hospital, Sweden.
FAU - Ekberg, Sara
AU  - Ekberg S
AD  - Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet and 
      Karolinska University Hospital, Stockholm, Sweden.
AD  - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Jerkeman, Mats
AU  - Jerkeman M
AD  - Department of Oncology, Skane University Hospital, Lund, Sweden.
FAU - Chang, Ellen T
AU  - Chang ET
AD  - California and Department of Health Research and Policy, Health Sciences 
      Practice, Exponent, Inc., Menlo Park, Stanford University School of Medicine, 
      Stanford, California.
FAU - Bjorkholm, Magnus
AU  - Bjorkholm M
AD  - Department of Medicine Division of Hematology, Karolinska University Hospital and 
      Karolinska Institutet, Stockholm, Sweden.
FAU - Andersson, Therese M L
AU  - Andersson TM
AD  - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 
      Stockholm, Sweden.
FAU - Smedby, Karin E
AU  - Smedby KE
AD  - Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet and 
      Karolinska University Hospital, Stockholm, Sweden.
FAU - Eloranta, Sandra
AU  - Eloranta S
AD  - Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet and 
      Karolinska University Hospital, Stockholm, Sweden.
LA  - eng
PT  - Historical Article
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20151006
PL  - United States
TA  - Am J Hematol
JT  - American journal of hematology
JID - 7610369
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Cohort Studies
MH  - Female
MH  - History, 20th Century
MH  - History, 21st Century
MH  - Hodgkin Disease/*mortality/pathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Survival Analysis
MH  - Sweden
MH  - Young Adult
EDAT- 2015/09/09 06:00
MHDA- 2016/06/03 06:00
CRDT- 2015/09/09 06:00
PHST- 2015/09/02 00:00 [received]
PHST- 2015/09/04 00:00 [accepted]
PHST- 2015/09/09 06:00 [entrez]
PHST- 2015/09/09 06:00 [pubmed]
PHST- 2016/06/03 06:00 [medline]
AID - 10.1002/ajh.24184 [doi]
PST - ppublish
SO  - Am J Hematol. 2015 Dec;90(12):1128-34. doi: 10.1002/ajh.24184. Epub 2015 Oct 6.