Baseline demographics and early outcome data from classical Hodgkin lymphoma (cHL) cases in the Lymphoma and Related Diseases Registry (LaRDR) are consistent with that of other international registries.
Data from 498 eligible patients registered across 23 sites in Australia between July 2016 and February 2022 shows that most are male (56%) with a median age of 36 years.
Most patients (58%) had advanced-stage disease and 38% of those had a high risk International Prognostic Score (IPS (IPS ≥5).
More than a third of patients (39%) were subtyped as nodular sclerosing cHL (NSCHL) while 53% were recorded as cHL “not otherwise specified”.
ABVD was the most common initial therapy for both early-stage disease (88%) and advanced-stage disease (61%) consistent with European Society of Medical Oncology and British Society of Haematology guidelines.
In advanced-stage and early-stage disease, escBEACOPP was given in 13% and 2% of patients, respectively.
“Greater diversity of therapy was observed in the elderly and comorbid group (seven different regimens among 22 [advanced-stage] patients) and this heterogeneity of our data demonstrates the challenges clinicians face in treating this group consistently due to the paucity of strong evidence-based recommendations in clinical practice guidelines,” the investigators said.
“In early-stage disease, 48% of patients received radiation therapy with 83% of those with a known dose receiving a maximum dose of either 20Gy or 30Gy; 12 patients received 20Gy and 13 received 30Gy.”
The study, published in the European Journal of Haematology [link here], said the objective response rate (ORR) in early-stage disease was 96% – comparable with international trial data – and the complete response (CR) rate 90%.
In advanced-stage disease, the ORR was 88% and the CR rate was 79%, with significant variation between ABVD therapy and escBEACOPP (79% v 94%, p = 0.01).
“Although these outcomes are supported by the 12-month PFS of 92% in early-stage disease and 83% in advanced-stage disease, this assessment is limited by the relatively short median follow-up of 18 months to date.”
The LaRDR investigators, led by Dr James Nguyen from Eastern Health, Victoria, said the findings provide confidence when extrapolating international trial results to the Australian population.
“These findings on the epidemiology and current treatment patterns of Australian patients with cHL will also be valuable in interpreting future clinical outcomes data and planning clinical trials.”
LaRDR has now has enrolled more than 5,800 patients of all lymphoma types from over 37 participating sites with expansion to New Zealand underway, and ongoing follow-up of the cohort.