Analysis of Predictors of Progression-Free Survival and Early Response in Young Adult Classical Hodgkin Lymphoma

Objective: Classical Hodgkin lymphoma (HL) is a common malignancy among adolescents and young adults (AYA). As this age group has biological, clinical and psychosocial differences compared to other age groups, it is referred to as the AYA group. The present study aimed to evaluate young adult patients diagnosed with classical HL at our center and identify predictors of complete response (CR) at interim evaluation and progression-free survival (PFS). Material and Method: Patients aged 18-39 years diagnosed with classical HL who were treated and followed up at our centre between 2015 and 2023 were retrospectively analysed. Results: The median age of 54 patients was 30 years and 53,7% were female. The most common subtype was nodular sclerosis (61,1%), with 40% of patients in stage II and 51,9% in advanced stages at diagnosis. Among early-stage patients, 53.8% were categorized as unfavorable risk, whereas 46.4% and 7.1% of advanced-stage patients were classified as intermediate and high risk, respectively. In the first- line treatment, 92,6% of patients were treated with the ABVD protocol. At the interim evaluation, the CR rate was 66,1%, while the CR rate at the end of treatment was 88%. The mortality rate was 3,7% during a median follow-up of 47,5 months. The mean overall survival was 107.407 (3.16) (95% CI) months. The mean PFS was 83,5 months, with no statistically significant difference between the early CR and non-CR groups (p = 0.197). When the predictors of PFS and CR at interim assessment were analysed in multivariate analyses, no significant variables were found. Conclusion: In our study, our results are similar to the literature and the survival and response rates in patient population, almost all of whom were on the ABVD protocol, are also encouraging. Despite analyzing potential predictors of PFS and early CR for guiding treatment and follow-up, no significant factors were identified. Furthermore, achieving early CR did not significantly impact PFS.