{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T11:36:29Z","timestamp":1792496189813,"version":"4.5.0"},"reference-count":32,"publisher":"American Society of Hematology","issue":"26","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon histologic variant, and the optimal treatment of stage I-II NLPHL is undefined. We conducted a multicenter retrospective study including patients \u226516 years of age with stage I-II NLPHL diagnosed from 1995 through 2018 who underwent all forms of management, including radiotherapy (RT), combined modality therapy (CMT; RT+chemotherapy [CT]), CT, observation after excision, rituximab and RT, and single-agent rituximab. End points were progression-free survival (PFS), freedom from transformation, and overall survival (OS) without statistical comparison between management groups. We identified 559 patients with median age of 39 years: 72.3% were men, and 54.9% had stage I disease. Median follow-up was 5.5 years (interquartile range, 3.1-10.1). Five-year PFS and OS in the entire cohort were 87.1% and 98.3%, respectively. Primary management was RT alone (n = 257; 46.0%), CMT (n = 184; 32.9%), CT alone (n = 47; 8.4%), observation (n = 37; 6.6%), rituximab and RT (n = 19; 3.4%), and rituximab alone (n = 15; 2.7%). The 5-year PFS rates were 91.1% after RT, 90.5% after CMT, 77.8% after CT, 73.5% after observation, 80.8% after rituximab and RT, and 38.5% after rituximab alone. In the RT cohort, but not the CMT cohort, variant immunoarchitectural pattern and number of sites &amp;gt;2 were associated with worse PFS (P &amp;lt; .05). Overall, 21 patients (3.8%) developed large-cell transformation, with a significantly higher transformation rate in those with variant immunoarchitectural pattern (P = .049) and number of involved sites &amp;gt;2 (P = .0006). OS for patients with stage I-II NLPHL was excellent after all treatments.<\/jats:p>","DOI":"10.1182\/blood.2019003877","type":"journal-article","created":{"date-parts":[[2020,3,25]],"date-time":"2020-03-25T18:00:12Z","timestamp":1585159212000},"page":"2365-2374","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":51,"title":["Stage I-II nodular lymphocyte-predominant Hodgkin lymphoma: a multi-institutional study of adult patients by ILROG"],"prefix":"10.1182","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2640-5255","authenticated-orcid":false,"given":"Michael S.","family":"Binkley","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA;"},{"name":"Radiation Oncology, Stanford University School of Medicine, Stanford, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Shahzad","family":"Rauf","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0037-6967","authenticated-orcid":false,"given":"Sarah A.","family":"Milgrom","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsea C.","family":"Pinnix","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Tsang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Princess Margaret Cancer Center, Toronto, ON, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1492-5966","authenticated-orcid":false,"given":"Michael","family":"Dickinson","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea K.","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, MA;"},{"name":"Radiation Oncology, Harvard University School of Medicine, Boston, MA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth B.","family":"Roberts","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Yale University, New Haven, CT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Yale University, New Haven, CT;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Balogh","sequence":"first","affiliation":[{"name":"Tom Baker Cancer Center, Calgary, AB, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Ricardi","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Turin, Torino, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7668-3296","authenticated-orcid":false,"given":"Mario","family":"Levis","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Turin, Torino, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Casulo","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stolten","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Rochester, Rochester, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6902-2190","authenticated-orcid":false,"given":"Lena","family":"Specht","sequence":"first","affiliation":[{"name":"Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Plastaras","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8615-0509","authenticated-orcid":false,"given":"Christopher","family":"Wright","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Kelsey","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Duke University School of Medicine, Durham, NC;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-5503","authenticated-orcid":false,"given":"Jessica L.","family":"Brady","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, Guy\u2019s Cancer Centre, Guy\u2019s and St Thomas\u2019 NHS Hospital, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0359-0328","authenticated-orcid":false,"given":"N. George","family":"Mikhaeel","sequence":"first","affiliation":[{"name":"Department of Clinical Oncology, Guy\u2019s Cancer Centre, Guy\u2019s and St Thomas\u2019 NHS Hospital, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2312-5418","authenticated-orcid":false,"given":"Bradford S.","family":"Hoppe","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of Florida, Gainesville, FL;"},{"name":"Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie A.","family":"Terezakis","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Picardi","sequence":"first","affiliation":[{"name":"Department of Clinical Medicine and Surgery, 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