Hodgkin transformation of chronic lymphocytic leukemia: Incidence, outcomes, and comparison to de novo Hodgkin lymphoma

Sameer A Parikh, Thomas Matthew Habermann, Kari G. Chaffee, Timothy G. Call, Wei D Ding, Jose F. Leis, William R. Macon, Susan M. Schwager, Kay M. Ristow, Luis F. Porrata, Neil Elliot Kay, Susan L Slager, Tait D. Shanafelt

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Abstract

Although transformation to Hodgkin lymphoma (HL) is a recognized complication in patients with chronic lymphocytic leukemia (CLL), its incidence, clinical characteristics and outcomes are not well defined. We used the Mayo Clinic CLL and Lymphoma Databases to identify CLL patients who developed biopsy-proven HL (CLL/HL) on follow-up, as well as cases of de novo HL (i.e., without prior CLL). Among 3887 CLL patients seen at Mayo Clinic from January 1995 through August 2011, 26 (0.7%) developed HL. In a nested cohort of 2,465 newly diagnosed CLL patients followed prospectively, the incidence of HL was 0.05%/year (10 year risk=0.5%). The median overall survival (OS) from date of HL diagnosis in patients with CLL/HL was 3.9 years compared to not reached for de novo HL patients (n=709) seen during the same time interval (P<0.001). The shorter OS of CLL/HL patients persisted after adjusting for differences in age and Ann Arbor stage of disease. The International Prognostic score (IPS) developed for de novo HL stratified prognosis among CLL/HL patients with median survival of not reached, 6.2, 2.4, and 0.3 years (P=0.006) for those with IPS scores of ≤2, 3, 4, and ≥5, respectively. In summary, approximately 1 of every 200 CLL patients will develop HL within 10 years. Survival after HL diagnosis in patients with CLL is shorter than de novo HL patients. The IPS for de novo HL may be useful for stratifying survival in CLL/HL patients.

Original languageEnglish (US)
Pages (from-to)334-338
Number of pages5
JournalAmerican Journal of Hematology
Volume90
Issue number4
DOIs
StatePublished - Apr 1 2015

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B-Cell Chronic Lymphocytic Leukemia
Hodgkin Disease
Incidence
Survival

ASJC Scopus subject areas

  • Hematology

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Hodgkin transformation of chronic lymphocytic leukemia : Incidence, outcomes, and comparison to de novo Hodgkin lymphoma. / Parikh, Sameer A; Habermann, Thomas Matthew; Chaffee, Kari G.; Call, Timothy G.; Ding, Wei D; Leis, Jose F.; Macon, William R.; Schwager, Susan M.; Ristow, Kay M.; Porrata, Luis F.; Kay, Neil Elliot; Slager, Susan L; Shanafelt, Tait D.

In: American Journal of Hematology, Vol. 90, No. 4, 01.04.2015, p. 334-338.

Research output: Contribution to journalArticle

Parikh, Sameer A ; Habermann, Thomas Matthew ; Chaffee, Kari G. ; Call, Timothy G. ; Ding, Wei D ; Leis, Jose F. ; Macon, William R. ; Schwager, Susan M. ; Ristow, Kay M. ; Porrata, Luis F. ; Kay, Neil Elliot ; Slager, Susan L ; Shanafelt, Tait D. / Hodgkin transformation of chronic lymphocytic leukemia : Incidence, outcomes, and comparison to de novo Hodgkin lymphoma. In: American Journal of Hematology. 2015 ; Vol. 90, No. 4. pp. 334-338.
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abstract = "Although transformation to Hodgkin lymphoma (HL) is a recognized complication in patients with chronic lymphocytic leukemia (CLL), its incidence, clinical characteristics and outcomes are not well defined. We used the Mayo Clinic CLL and Lymphoma Databases to identify CLL patients who developed biopsy-proven HL (CLL/HL) on follow-up, as well as cases of de novo HL (i.e., without prior CLL). Among 3887 CLL patients seen at Mayo Clinic from January 1995 through August 2011, 26 (0.7{\%}) developed HL. In a nested cohort of 2,465 newly diagnosed CLL patients followed prospectively, the incidence of HL was 0.05{\%}/year (10 year risk=0.5{\%}). The median overall survival (OS) from date of HL diagnosis in patients with CLL/HL was 3.9 years compared to not reached for de novo HL patients (n=709) seen during the same time interval (P<0.001). The shorter OS of CLL/HL patients persisted after adjusting for differences in age and Ann Arbor stage of disease. The International Prognostic score (IPS) developed for de novo HL stratified prognosis among CLL/HL patients with median survival of not reached, 6.2, 2.4, and 0.3 years (P=0.006) for those with IPS scores of ≤2, 3, 4, and ≥5, respectively. In summary, approximately 1 of every 200 CLL patients will develop HL within 10 years. Survival after HL diagnosis in patients with CLL is shorter than de novo HL patients. The IPS for de novo HL may be useful for stratifying survival in CLL/HL patients.",
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T1 - Hodgkin transformation of chronic lymphocytic leukemia

T2 - Incidence, outcomes, and comparison to de novo Hodgkin lymphoma

AU - Parikh, Sameer A

AU - Habermann, Thomas Matthew

AU - Chaffee, Kari G.

AU - Call, Timothy G.

AU - Ding, Wei D

AU - Leis, Jose F.

AU - Macon, William R.

AU - Schwager, Susan M.

AU - Ristow, Kay M.

AU - Porrata, Luis F.

AU - Kay, Neil Elliot

AU - Slager, Susan L

AU - Shanafelt, Tait D.

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N2 - Although transformation to Hodgkin lymphoma (HL) is a recognized complication in patients with chronic lymphocytic leukemia (CLL), its incidence, clinical characteristics and outcomes are not well defined. We used the Mayo Clinic CLL and Lymphoma Databases to identify CLL patients who developed biopsy-proven HL (CLL/HL) on follow-up, as well as cases of de novo HL (i.e., without prior CLL). Among 3887 CLL patients seen at Mayo Clinic from January 1995 through August 2011, 26 (0.7%) developed HL. In a nested cohort of 2,465 newly diagnosed CLL patients followed prospectively, the incidence of HL was 0.05%/year (10 year risk=0.5%). The median overall survival (OS) from date of HL diagnosis in patients with CLL/HL was 3.9 years compared to not reached for de novo HL patients (n=709) seen during the same time interval (P<0.001). The shorter OS of CLL/HL patients persisted after adjusting for differences in age and Ann Arbor stage of disease. The International Prognostic score (IPS) developed for de novo HL stratified prognosis among CLL/HL patients with median survival of not reached, 6.2, 2.4, and 0.3 years (P=0.006) for those with IPS scores of ≤2, 3, 4, and ≥5, respectively. In summary, approximately 1 of every 200 CLL patients will develop HL within 10 years. Survival after HL diagnosis in patients with CLL is shorter than de novo HL patients. The IPS for de novo HL may be useful for stratifying survival in CLL/HL patients.

AB - Although transformation to Hodgkin lymphoma (HL) is a recognized complication in patients with chronic lymphocytic leukemia (CLL), its incidence, clinical characteristics and outcomes are not well defined. We used the Mayo Clinic CLL and Lymphoma Databases to identify CLL patients who developed biopsy-proven HL (CLL/HL) on follow-up, as well as cases of de novo HL (i.e., without prior CLL). Among 3887 CLL patients seen at Mayo Clinic from January 1995 through August 2011, 26 (0.7%) developed HL. In a nested cohort of 2,465 newly diagnosed CLL patients followed prospectively, the incidence of HL was 0.05%/year (10 year risk=0.5%). The median overall survival (OS) from date of HL diagnosis in patients with CLL/HL was 3.9 years compared to not reached for de novo HL patients (n=709) seen during the same time interval (P<0.001). The shorter OS of CLL/HL patients persisted after adjusting for differences in age and Ann Arbor stage of disease. The International Prognostic score (IPS) developed for de novo HL stratified prognosis among CLL/HL patients with median survival of not reached, 6.2, 2.4, and 0.3 years (P=0.006) for those with IPS scores of ≤2, 3, 4, and ≥5, respectively. In summary, approximately 1 of every 200 CLL patients will develop HL within 10 years. Survival after HL diagnosis in patients with CLL is shorter than de novo HL patients. The IPS for de novo HL may be useful for stratifying survival in CLL/HL patients.

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