Results of the Russian Multi-Center Cooperative Prospective-Retrospective Observational Program for Hodgkin’s Lymphoma Treatment RNWOHG-HD1

AUTOIMMUNE THROMBOCYTOPENIA ,

IS Moiseev1, SM Alekseev2,24, NB Mikhailova1, KD Kaplanov3,21, MV Demchenkova4, LV Anchukova5, VV Baikov1, AM Belyaev2, YuA Vasil’eva6, NP Volkov1, YuN Vinogradova7, AYu Zaritskey8, AE Zdorov9, NV Il’in7, LO Kashintseva10, EV Kondakova1, PV Kotselyabina1, VA Lapin11, KV Lepik1, IV Lesechko12, VM Moiseenko13, GM Manikhas14, NV Medvedeva15, YuA Oleinik2, ES Pavlyuchenko16, KS Parfenova17, EV Patrakova18, AV Proidakov19, DV Saidullaeva20, EV Tarasova21, AL Shipaeva22, TV Shneider23, BV Afanasyev1

1 RM Gorbacheva Scientific Research Institute of Pediatric Oncology, Hematology and Transplantation; IP Pavlov First Saint Petersburg State Medical University, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022

2 NN Petrov National Medical Cancer Research Center, 68 Leningradskaya str., Pesochnyi settlement, Saint Petersburg, Russian Federation, 197758

3 SP Botkin Municipal Clinical Hospital, 5 2-i Botkinskii pr-d, Moscow, Russian Federation, 125284

4 Regional Oncology Dispensary, 32 Frunze str., Irkutsk, Russian Federation, 664035

5 Vologda Regional Clinical Hospital, 17 Lechebnaya str., Vologda, Russian Federation, 160002

6 Pskov Oncology Dispensary, 15a Vokzalnaya str., Pskov, Russian Federation, 180004

7 AM Granov Russian Research Centre for Radiology and Surgical Technologies, 70 Leningradskaya str., Pesochnyi settlement, Saint Petersburg, Russian Federation, 197758

8 VA Almazov National Medical Research Center, 2 Akkuratova str., Saint Petersburg, Russian Federation, 197341

9 VA Baranov Republican Hospital, 3 Pirogova str. (Perevalka district), Petrozavodsk, Republic of Karelia, Russian Federation, 185002

10 Tula Regional Clinical Hospital, 1a Yablochkova str., Tula, Russian Federation, 300053

11 Yaroslavl Regional Clinical Hospital, 7 Yakovlevskaya str., Yaroslavl, Russian Federation, 150062

12 Stavropol Krai Clinical Oncology Dispensary, 182a Oktyabrskaya str., Stavropol, Russian Federation, 355047

13 Saint Petersburg Clinical Applied Research Center for Specialized Types of Medical Care (Oncology), 68A Leningradskaya str., Pesochnyi settlement, Saint Petersburg, Russian Federation, 197758

14 Municipal Clinical Oncology Dispensary, 3/5 2-ya Berezovaya alley, Saint Petersburg, Russian Federation, 197022

15 Municipal Clinical Hospital No. 31, 3 Dinamo pr-t, Saint Petersburg, Russian Federation, 197110

16 EE Eikhvald Clinic, II Mechnikov North-Western State Medical University, 41 bld. 7 Kirochnaya str., Saint Petersburg, Russian Federation, 191123

17 Samara Regional Clinical Oncology Dispensary, 11 Solnechnaya str., Syzran, Russian Federation, 446020

18 Vologda Regional Clinical Hospital No. 2, 15 Danilova str., Cherepovets, Vologda Region, Russian Federation, 162602

19 Komi Republican Oncology Dispensary, 46 Nyuvchimskoe sh., Krasnozatonskii town settlement, Syktyvkar, Republic of Komi, Russian Federation, 167904

20 Tver Regional Oncology Dispensary, 57/37 15 let Oktyabrya str., Tver, Russian Federation, 170008

21 First Republican Clinical Hospital, 57 Votkinskoe sh., Izhevsk, Russian Federation, 426039

22 Volgograd Regional Clinical Oncology Dispensary, 78 Zemlyachki str., Volgograd, Russian Federation, 400138

23 Leningrad Regional Clinical Hospital, 45 bld. 2A Lunacharskogo pr-t, Saint Petersburg, Russian Federation, 194291

24 LD Roman Leningrad Regional Clinical Oncology Dispensary, 2 Zaozernaya str., Kuzmolovskii settlement, Vsevolozhskii district, Leningrad Region, Russian Federation, 188663

For correspondence: Ivan Sergeevich Moiseev, MD, PhD, 6/8 L’va Tolstogo str., Saint Petersburg, Russian Federation, 197022; Tel.: 8(812)338-62-65; e-mail: moisiv@mail.ru

For citation: Moiseev IS, Alekseev SM, Mikhailova NB, et al. Results of the Russian Multi-Center Cooperative Prospective-Retrospective Observational Program for Hodgkin’s Lymphoma Treatment RNWOHG-HD1. Clinical oncohematology. 2021;14(4):455–65. (In Russ).

DOI: 10.21320/2500-2139-2021-14-4-455-465

ABSTRACT

Aim. The observational program was aimed at obtaining data on classical Hodgkin’s lymphoma (cHL) incidence in the Russian Federation, therapy options, and clinical outcomes of treatment. The aim of the prospective part of the program was to standardize the approaches to therapy and to compare its outcomes with off-protocol treatment.

Materials & Methods. The prospective-retrospective observational program for Hodgkin’s lymphoma treatment engaged 32 regional and federal centers. It included 218 patients, 21 out of them were included into the prospective part of the RNWOHG-HD1 (Russian North-West Oncology and Hematology Group — Hodgkin Disease Study 1) program. The median age was 36 years (range 22–87 years). cHL stages I/II were identified in 48 % of patients, III/IV stages were reported in 52 % of patients. The prospective part of the program used escalating protocol in patients with stages I/IIA and without risk factors and de-escalating protocol in patients with advanced stages. Overall (OS) and progression-free (PFS) survivals were analyzed in 160 and 152 patients, respectively. PET-CT was used to assess the response in 33 % of patients.

Results. The study used the following first-line chemotherapy regimens: ABVD in 42 %, BEACOPPst in 11 %, BEACOPP-14 in 17 %, BEACOPPesc in 25 %, and EACOPP in 1 % of cases. After the completion of first-line therapy objective response rate was 91 % including 61 % of complete responses. Response structure did not significantly differ in the groups of non-intensive therapy (ABVD and BEACOPPst), intensified regimens (BEACOPP-14, BEACOPPesc, and EACOPP), and treatment according to the RNWOHG-HD1 protocol (91 %, 92 %, and 96 %, respectively; p = 0.7226). In the total cohort the 3-year OS was 97 % (95% confidence interval [95% CI] 94–99 %), PFS was 87 % (95% CI 80–92 %). The 3-year PFS did not differ in ABVD, BEACOPPst, BEACOPP-14, BEACOPPesc, and RNWOHG-HD1 recipients (p = 0.37). International Prognostic Score (IPS) yielded significant results in PFS prediction for patients with IPS score of 5–6, but not for those with IPS score of 1–4 (p = 0.0028).

Conclusion. The observational program showed that the majority of participating centers use the risk-adapted ABVD/BEACOPPesc approach which explains no difference in PFS being found with the use of these chemotherapy options. The study demonstrated the need for PET-CT to assess the response since the CT alone cannot distinguish between complete and partial responses in a considerable number of patients. The prospective unified program for cHL treatment may well be implemented in the Russian Federation.

Keywords: classical Hodgkin’s lymphoma, multi-center study, ABVD, BEACOPP, positron emission tomography, risk-adapted therapy.

Received: May 25, 2021

Accepted: August 30, 2021

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