{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:19:39Z","timestamp":1790313579433,"version":"4.1.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cancer"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon variant of Hodgkin lymphoma. There is limited data on treatment, management of refractory and relapsed disease, and long-term outcome. Many registries or country-wide data reports are unable to provide detailed primary and subsequent management. We are reporting our observation on patient\u2019s characteristics, management, and outcome.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This single-institution retrospective cohort analysis includes NLPHL patients seen from 1998 to July 2019. We used Fisher\u2019s exact test, chi-square, and Kaplan-Meier (KM) method for various analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred patients were identified, (6.34% of all the HL). Male:female was 3:1. The median age at diagnosis was 22\u2009years (4\u201379\u2009years). Stage I-II in 145 (72.5%) cases. One hundred patients (50%) received chemotherapy, 68 (34%) chemotherapy + radiation therapy (RT); 87% of all chemotherapy was ABVD (adriamycin, bleomycin, vinblastine, dacarbazine). Thirteen patients (6.5%) received RT alone and 16 (8%) had surgery alone. Complete response in 82%, partial response in 5.5% and progressive disease in 10.5%. The median follow is 60\u2009months (5\u2013246). Median 5 and 10\u2009years overall survival (OS) is 94.8 and 92.4% (stages I-II, 97.7 and 97.7%, stage III-IV, 94.8 and 92.4%). Median event-free survival (EFS) is 62.3 and 54% respectively (stage I-II, 72 and 64%, stage III-IV, 36.4 and 18.2%). Stage I-II vs III-IV OS (<jats:italic>p<\/jats:italic>\u00a0=\u2009&lt;\u20090.001) and EFS (<jats:italic>p<\/jats:italic>\u00a0=\u2009&lt;\u20090.001) were significant. For stage I-II, 5\u2009year EFS of chemotherapy + RT (83.3%) was superior to chemotherapy alone (60%, <jats:italic>p<\/jats:italic>\u00a0=\u20090.008). Five\u2009year EFS for early favorable (80%), early unfavorable (60%), and advanced (36.4%) was significant (<jats:italic>p<\/jats:italic>\u00a0=\u2009&lt;\u20090.001). Eleven patients (5.5%) had high-grade transformation. Twenty-nine patients underwent HDC auto-SCT, all are alive (28 in remission). 25% of patients had pathologically proved nodal hyperplasia at some point in time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>OS of NLPHL is excellent and independent of treatment type. EFS is better for chemotherapy + RT than chemotherapy alone. Stem cell transplant in refractory \/ multiple relapses resulted in excellent disease control. There is a need to identify optimal treatment strategies accordingly to the risk stratification.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12885-021-08074-2","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T15:03:14Z","timestamp":1617289394000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Nodular lymphocyte-predominant Hodgkin lymphoma characteristics, management of primary and relapsed\/refractory disease and outcome analysis: the first comprehensive report from the Middle East"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-0944","authenticated-orcid":false,"given":"Saad","family":"Akhtar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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