Young patients with classic Hodgkin lymphoma (cHL) have a low risk of relapse with current treatments and may not need intensive follow up if they achieve event-free survival of two years, according to a ‘real world’ study from Scandinavia.

Analysis of a cohort of 2,582 Nordic patients with cHL diagnosed at ages 18 to 49 years between 2000 and 2013 showed that the 5-year overall survival rate was 95% and the 5-year risk of relapse was 13.4% overall.

However the risk of relapse decreased to 4.2% among patients who reached event free survival of 24 months, and 1.3% for those who reached an event-free survival of 60 months, according to researchers at Karolinska Institute in Sweden.

In their study the median follow-up time was nine years, and the relapse risk was comparable for patients treated with six to eight courses of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) or a similar numbers of courses of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD).

The reduction in life expectancy for treated patients was small, being 45 days for patients overall and 13 days for patients who reached EFS24.

In stage-stratified analyses of 5-year restricted loss in expectation of lifetime,  there was no noteworthy excess risk of death for patients with patients with stages I to IIA disease after they reached EFS24, although risk remained measurable for patients with stages IIB to IV disease.

Study co- author Dr Karin Ekström Smedby, of the Karolinska Institutet’s Department of Medicine said young patients with cHL currently are being monitored for relapse for five years after treatment.

But the good outcomes seen for young patients suggested this may not be necessary for those who remain relapse free for two years, she said.

“Bearing in mind the good survival rate and low risk of relapse after two years, the frequency of check-ups for detecting relapse could be greatly reduced after this time,” says

“That said, further checks are needed at a later stage to find and treat delayed adverse reactions to the treatment.”

The findings are published in the Journal of Clinical Oncology.