Historical outcomes for patients with stage IA NLPHL: RGlobal nLPHL One Working Group (GLOW) retrospective analyses

We evaluated outcomes by management type for patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in the Global NLPHL One Working Group (GLOW) retrospective database of 2243 patients with stage I-IV disease diagnosed from 1992-2021 at 38 international institutions. 779 patients were stage IA with median age of 35 years (range=3-89) and median follow-up of 6.1 years. The 6-year PFS and OS were 86.3% and 97.7%, respectively. Outcomes were analyzed for two groups: complete resection and unresected disease. Patients with a complete resection and observation alone (n=99) had a 6-year PFS of 65.5% versus 90.5% for those who received RT (n=53). Patients with unresected disease (n=627; 80.5%) had a 6-year PFS of 62.0% for rituximab alone (n=31), 89.6% for RT alone (n=325), 76.8% for ABVD alone (n=40), and 94.3% for ABVD+RT (n=130). 127 patients relapsed (16.3%), of which 25 (19.7%) had transformation. Our analysis suggests 1) RT improves the PFS in patients with completely resected disease; 2) Rituximab or ABVD alone do not appear to achieve a durable response; 3) Chemotherapy was not observed to add additional PFS benefit when used in combination with RT. Thus, for stage IA NLPHL, RT alone is likely sufficient for definitive treatment.

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Journal
Blood Advances
Published
2026-04-14
DOI
https://doi.org/10.1182/bloodadvances.2026020012
Primary Topic
Lymphoma Diagnosis and Treatment
Type
article
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article

Historical outcomes for patients with stage IA NLPHL: RGlobal nLPHL One Working Group (GLOW) retrospective analyses

Yasodha Natkunam, Louis S. Constine, Isabela Chang, Eliza A. Hawkes et al.
Blood Advances
Lymphoma Diagnosis and Treatment
article

Historical outcomes for patients with stage IA NLPHL: RGlobal nLPHL One Working Group (GLOW) retrospective analyses

Yasodha Natkunam, Louis S. Constine, Isabela Chang, Eliza A. Hawkes, Nicholas Viiala, Chris R. Kelsey, Lindsay Blazin, Chelsea C. Pinnix, Monica Palese, G. Mikhaeel, Kerry J. Savage, Gukan Sakthivel, Aditya Tedjaseputra, Anca A. Prica, Egor Volchkov, Peter G. Hendrickson, Priyadarshini Kumar, Jalila Alkendi, Howard Mutsando, Jamie E. Flerlage, Michael S. Binkley, Dipti Talaulikar, Mohammed Alomari, Kenneth B. Roberts, Pallawi Torka, R. Steiner, Keir Pickard, Dennis A. Eichenauer, Richard Tsang, Fiona Miall, Bernadette Brennan, Carla Casulo, Allison Barraclough, Wendy Osborne, Chan Yoon Cheah, Ajay Major, Mario Levis, Ravi De Silva, Irfan Maghfoor, Richard T. Hoppe, M. Shahzad Rauf, Bradford S. Hoppe, Nicole Wong Doo, Lena Specht, Andrea Lo, Julie L. Koenig, R Della Pepa, Tamara Marconi, Ross Salvaris, John P. Plastaras, Stephen Opat, Xiaoyin Zhang, Michael John Dickinson, SD Smith, Marie Reeves, Andrea K. Ng, Saad Akhtar, Andrew Wirth, Anthony Penn, Paige Fergusson, Michael Northend, Nasser Al Rahbi, Francisco Vega, Pamela McKay, Nada Hamad, P Borchmann, Sarah A. Milgrom, Hans Theodor Eich, Stephanie A Terezakis, Graham P. Collins, Michael Fuchs, David Hopkins, Mariia Senchenko, Jonathan A Baron, Youlia Kirova, Kara M Kelly, Christine Moore Smith, Akshay Sridhar, Matthew Ku, Michael Gilbertson, Michael Henry, Brian Skinnider, Ranjana H Advani, Daniel Halperin, Umberto Ricardi, Alexander George Balogh, Ananth G Shankar, Nimish Shah, Sarah Gao, Marco Picardi, Matthew J Maurer
article en

Abstract

We evaluated outcomes by management type for patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in the Global NLPHL One Working Group (GLOW) retrospective database of 2243 patients with stage I-IV disease diagnosed from 1992-2021 at 38 international institutions. 779 patients were stage IA with median age of 35 years (range=3-89) and median follow-up of 6.1 years. The 6-year PFS and OS were 86.3% and 97.7%, respectively. Outcomes were analyzed for two groups: complete resection and unresected disease. Patients with a complete resection and observation alone (n=99) had a 6-year PFS of 65.5% versus 90.5% for those who received RT (n=53). Patients with unresected disease (n=627; 80.5%) had a 6-year PFS of 62.0% for rituximab alone (n=31), 89.6% for RT alone (n=325), 76.8% for ABVD alone (n=40), and 94.3% for ABVD+RT (n=130). 127 patients relapsed (16.3%), of which 25 (19.7%) had transformation. Our analysis suggests 1) RT improves the PFS in patients with completely resected disease; 2) Rituximab or ABVD alone do not appear to achieve a durable response; 3) Chemotherapy was not observed to add additional PFS benefit when used in combination with RT. Thus, for stage IA NLPHL, RT alone is likely sufficient for definitive treatment.

Blood Advances
Niagara County Community College (US), University of Copenhagen (DK), BC Cancer Agency (CA), Roswell Park Comprehensive Cancer Center (US), St. Jude Children's Research Hospital (US), The Royal Melbourne Hospital (AU), Mayo Clinic (US), Memorial Sloan Kettering Cancer Center (US), University College London Hospitals NHS Foundation Trust (GB), The University of Texas MD Anderson Cancer Center (US), Harvard University (US), Johns Hopkins University (US), Duke University (US), University of Cologne (DE), King's College London (GB), Guy's and St Thomas' NHS Foundation Trust (GB), University of Münster (DE), Norfolk and Norwich University Hospital (GB), Concord Repatriation General Hospital (AU), Wexham Park Hospital (GB), Beatson West of Scotland Cancer Centre (GB), Austin Hospital (AU), Peter MacCallum Cancer Centre (AU), Fiona Stanley Hospital (AU), Toowoomba Hospital (AU), Liverpool Hospital (AU), King Faisal Specialist Hospital & Research Centre (SA), Newcastle upon Tyne Hospitals NHS Foundation Trust (GB), Spinal Cord Injury BC (CA), Sir Charles Gairdner Hospital (AU), University Hospitals of Leicester NHS Trust (GB), Princess Margaret Cancer Centre (CA), Rigshospitalet (DK), Canberra Hospital (AU), University of Rochester Medical Center (US), Yale University (US), University of Chicago (US), St Vincent's Hospital Melbourne (AU), St Vincent's Hospital Sydney (AU), Eastern Health (AU), Birmingham Children's Hospital (GB), University Hospital Münster (DE), Occupational Cancer Research Centre (CA), Federico II University Hospital (IT), Dana-Farber Cancer Institute (US), Essen University Hospital (DE), Monash Health (AU), Phoenix Children's Hospital (US), Duke Medical Center (US), Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology (RU), Royal Hospital (OM), Stanford Medicine (US), Mayo Clinic in Florida (US), Oxford University Hospitals NHS Trust (GB), Centrum für Integrierte Onkologie (DE), University Hospital Cologne (DE), Olivia Newton-John Cancer Wellness & Research Centre (AU), Royal Manchester Children's Hospital (GB), Austin Health (AU), Indiana University School of Medicine, University College London (GB), University of Colorado Anschutz Medical Campus (US), University of Turin (IT), Indiana University – Purdue University Indianapolis (US), Monash University (AU), FH Münster University of Applied Sciences (DE), University of Pennsylvania (US), Institut Curie (FR), Vanderbilt University Medical Center (US), University of Colorado Denver (US), Stanford University (US)
Amgen, Bristol-Myers Squibb, AstraZeneca, Gilead Sciences, Celgene, Regeneron Pharmaceuticals, American Lebanese Syrian Associated Charities, BeiGene, Incyte, Seagen, Genentech, National Cancer Institute
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