Advanced stage classical Hodgkin lymphoma patients with a positive interim-PET (PET-2) Deauville score 5 after 2 ABVD cycles: a pooled analysis of three multicenter trials

PET after 2 ABVD cycles (PET-2) is widely adopted to select patients with classical Hodgkin lymphoma (cHL), who might benefit from intensifying or de-escalating therapy. Prolonged progression-free survival (PFS) has been reported in PET-2 positive patients switched to escalated BEACOPP (eBEACOPP) or BEACOPP-14. Nevertheless, the subgroup of patients with a PET-2 scored 5 according to Deauville score (PET-2 DS5) are known to poorly benefit from treatment intensification. To elucidate PET-2 DS5 outcome along with possible predictive factors of response to intensification, a pooled analysis from three multicenter trials, GITIL/FIL HD0607, RATHL, and SWOG S0816, was conducted. PFS and overall survival (OS) were assessed after 41-month median follow-up, the prognostic value of clinical, laboratory, and PET parameters at diagnosis was evaluated. Among 2231 patients, 136 (6%) PET-2 DS5 patients were identified. Their 3-year PFS was 32% (95% CI, 25-42), while the 3-year OS was 82% (95% CI, 75-89). In multivariate analysis low lymphocyte (< 600/mm<sup>3</sup>) counts were adversely associated with PFS, whereas age ≥ 45 years and leukocytes cells count <15 × 103/μL were barely associated with short OS. The study confirms on a suitable cohort of PET-2 DS5 patients, that this high-risk cHL subgroup has an inadequate response to treatment intensification. Nevertheless, PET-2 DS5 patients may still have good outcome after subsequent salvage treatments with > 80% survival at 3 years, thus excluding a real disease refractoriness. Few distinct parameters may have specific prediction for PFS or OS.

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Journal
Blood Cancer Journal
Published
2025-10-16
DOI
https://doi.org/10.1038/s41408-025-01364-z
Citations
1
Primary Topic
Lymphoma Diagnosis and Treatment
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article
Field-Weighted Citation Impact
1.47
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article

Advanced stage classical Hodgkin lymphoma patients with a positive interim-PET (PET-2) Deauville score 5 after 2 ABVD cycles: a pooled analysis of three multicenter trials

Luca Guerra, Heiko M. Schöder, Andrea Gallamini, Michael V. Knopp et al.
1 citations
Blood Cancer Journal
Lymphoma Diagnosis and Treatment
1.47
article

Advanced stage classical Hodgkin lymphoma patients with a positive interim-PET (PET-2) Deauville score 5 after 2 ABVD cycles: a pooled analysis of three multicenter trials

Luca Guerra, Heiko M. Schöder, Andrea Gallamini, Michael V. Knopp, Stefano Luminari, Amy A. Kirkwood, Deborah Marie Stephens, Chiara Pavoni, Jonathan W. Friedberg, Stéphane Chauvie, Sally F. Barrington, Paolo Corradini, Daniel Molin, Alessandro Rambaldi, Corrado Tarella, Peter Johnson, Simonetta Viviani
article en
1 citations

Abstract

PET after 2 ABVD cycles (PET-2) is widely adopted to select patients with classical Hodgkin lymphoma (cHL), who might benefit from intensifying or de-escalating therapy. Prolonged progression-free survival (PFS) has been reported in PET-2 positive patients switched to escalated BEACOPP (eBEACOPP) or BEACOPP-14. Nevertheless, the subgroup of patients with a PET-2 scored 5 according to Deauville score (PET-2 DS5) are known to poorly benefit from treatment intensification. To elucidate PET-2 DS5 outcome along with possible predictive factors of response to intensification, a pooled analysis from three multicenter trials, GITIL/FIL HD0607, RATHL, and SWOG S0816, was conducted. PFS and overall survival (OS) were assessed after 41-month median follow-up, the prognostic value of clinical, laboratory, and PET parameters at diagnosis was evaluated. Among 2231 patients, 136 (6%) PET-2 DS5 patients were identified. Their 3-year PFS was 32% (95% CI, 25-42), while the 3-year OS was 82% (95% CI, 75-89). In multivariate analysis low lymphocyte (< 600/mm<sup>3</sup>) counts were adversely associated with PFS, whereas age ≥ 45 years and leukocytes cells count <15 × 103/μL were barely associated with short OS. The study confirms on a suitable cohort of PET-2 DS5 patients, that this high-risk cHL subgroup has an inadequate response to treatment intensification. Nevertheless, PET-2 DS5 patients may still have good outcome after subsequent salvage treatments with > 80% survival at 3 years, thus excluding a real disease refractoriness. Few distinct parameters may have specific prediction for PFS or OS.

Blood Cancer JournalVol. 15(1)
University of North Carolina at Chapel Hill (US), Memorial Sloan Kettering Cancer Center (US), Uppsala University Hospital (SE), King's College London (GB), University of Milan (IT), Cancer Research UK (GB), The Ohio State University Wexner Medical Center (US), University of Rochester Medical Center (US), London Cancer (GB), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), Ospedale Papa Giovanni XXIII (IT), Azienda Ospedaliera San Gerardo (IT), Kings Health Partners (GB), Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo (IT), Centre Antoine Lacassagne (FR), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Fondazione IRCCS Istituto Nazionale dei Tumori (IT), University of Southampton (GB), University College London (GB), University of Rochester (US), European Institute of Oncology (IT), University of Milano-Bicocca (IT)
Openalex Percentile: Top 14%
Lymphoma Diagnosis and Treatment
1.47
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