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  • Glimelius, IngridKarolinska Institutet,Uppsala universitet,Experimentell och klinisk onkologi (författare)

Long-term survival in young and middle-aged Hodgkin lymphoma patients in Sweden 1992-2009 - trends in cure proportions by clinical characteristics.

  • Artikel/kapitelEngelska2015

Förlag, utgivningsår, omfång ...

  • 2015-10-06
  • Wiley,2015

Nummerbeteckningar

  • LIBRIS-ID:oai:lup.lub.lu.se:9fc009ab-7731-4632-bf81-c459cbd3703d
  • https://lup.lub.lu.se/record/8042881URI
  • https://doi.org/10.1002/ajh.24184DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-270353URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:132717425URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:art swepub-publicationtype
  • Ämneskategori:ref swepub-contenttype

Anmärkningar

  • 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 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 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 [CPstage:IIIB 0.82 (95%CI:0.73-0.89); CPstage: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. This article is protected by copyright. All rights reserved.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Ekberg, SKarolinska Institutet (författare)
  • Jerkeman, MatsLund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)onk-mje (författare)
  • Chang, E T (författare)
  • Björkholm, MKarolinska Institutet (författare)
  • Andersson, T M LKarolinska Institutet (författare)
  • Smedby, K EKarolinska Institutet (författare)
  • Eloranta, S (författare)
  • Uppsala universitetExperimentell och klinisk onkologi (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:American Journal of Hematology: Wiley90:12, s. 1128-11340361-86091096-8652

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