Historical outcomes for patients with stage IA NLPHL: Global NLPHL One Working Group retrospective analyses

Flerlage, JE; Steiner, R; Eichenauer, DA; Dickinson, M; Fuchs, M; Smith, S; Hartmann, S; Ng, A; Eich, HT; Koenig, J; Savage, KJ; Baron, J; Lo, AC; Balogh, A; Skinnider, B; Mikhaeel, G; Akhtar, S; Senchenko, MA; Rauf, MS; Hoppe, B; Maghfoor, I; Terezakis, S; Pinnix, CC; Hawkes, E; Doo, NW; Milgrom, SA; Shankar, A; Vega, F; Alomari, M; Zhang, XY; Collins, GP; Advani, RH; Kumar, P; Wirth, A; Tsang, R; Prica, A; Major, A; Hendrickson, PG; Kelsey, CR; Hopkins, D; McKay, P; Constine, LS; Casulo, C; Sakthivel, G; Plastaras, JP; Roberts, KB; Gao, S; Al Kendi, J; Al Rahbi, N; Levis, M; Ricardi, U; Sridhar, A; Torka, P; Specht, L; De Silva, R; Shah, N; Pickard, K; Osborne, W; Blazin, LJ; Henry, M; Chang, I; Smith, CM; Halperin, D; Miall, F; Brady, JL; Brennan, B; Penn, A; Volchkov, EV; Reeves, M; Talaulikar, D; Della Pepa, R; Picardi, M; Kirova, Y; Fergusson, P; Northend, M; Lee, D; Barraclough, A; Opat, S; Cheah, CY; Salvaris, R; Ku, M; Hamad, N; Mutsando, H; Tedjaseputra, A; Gilbertson, M; Marconi, T; Viiala, N; Palese, M; Maurer, MJ; Natkunam, Y; Kelly, KM; Borchmann, P; Hoppe, RT; Binkley, MS

Author(s): Flerlage, JE; Steiner, R; Eichenauer, DA; Dickinson, M; Fuchs, M; Smith, S; Hartmann, S; Ng, A; Eich, HT; Koenig, J; Savage, KJ; Baron, J; Lo, AC; Balogh, A; Skinnider, B; Mikhaeel, G; Akhtar, S; Senchenko, MA; Rauf, MS; Hoppe, B; Maghfoor, I; Terezakis, S; Pinnix, CC; Hawkes, E; Doo, NW; Milgrom, SA; Shankar, A; Vega, F; Alomari, M; Zhang, XY; Collins, GP; Advani, RH; Kumar, P; Wirth, A; Tsang, R; Prica, A; Major, A; Hendrickson, PG; Kelsey, CR; Hopkins, D; McKay, P; Constine, LS; Casulo, C; Sakthivel, G; Plastaras, JP; Roberts, KB; Gao, S; Al Kendi, J; Al Rahbi, N; Levis, M; Ricardi, U; Sridhar, A; Torka, P; Specht, L; De Silva, R; Shah, N; Pickard, K; Osborne, W; Blazin, LJ; Henry, M; Chang, I; Smith, CM; Halperin, D; Miall, F; Brady, JL; Brennan, B; Penn, A; Volchkov, EV; Reeves, M; Talaulikar, D; Della Pepa, R; Picardi, M; Kirova, Y; Fergusson, P; Northend, M; Lee, D; Barraclough, A; Opat, S; Cheah, CY; Salvaris, R; Ku, M; Hamad, N; Mutsando, H; Tedjaseputra, A; Gilbertson, M; Marconi, T; Viiala, N; Palese, M; Maurer, MJ; Natkunam, Y; Kelly, KM; Borchmann, P; Hoppe, RT; Binkley, MS;
Details: Publication Year 2026-08-11,Volume 10,Issue #15,Page 5338-5347
Journal Title: Blood Advances
Publication Type: Research article
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 retrospective database of 2243 patients with stages I to IV disease diagnosed from 1992 to 2021 at 38 international institutions. A total of 779 patients had stage IA disease with median age of 35 years (range, 3-89) and median follow-up of 6.1 years. The 6-year progression-free survival (PFS) and overall survival were 86.3% and 97.7%, respectively. Outcomes were analyzed for the 2 groups: complete resection and unresected disease. Patients with a complete resection and observation alone (n = 99) had a 6-year PFS of 65.5% vs 90.5% for those who received radiotherapy (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 (doxorubicin, bleomycin, vinblastine, dacarbazine) alone (n = 40), and 94.3% for ABVD plus RT (n = 130). A total of 127 patients relapsed (16.3%), of which 25 (19.7%) had transformation. Our analysis suggests the following: (1) RT improves the PFS in patients with completely resected disease; (2) rituximab or ABVD alone does not appear to achieve a durable response; and (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.
Publisher: American Society of Hematology
Keywords: Humans; Retrospective Studies; *Hodgkin Disease/therapy/mortality/pathology; Female; Neoplasm Staging; Adult; Male; Middle Aged; Adolescent; Child; Aged; Child, Preschool; Aged, 80 and over; Treatment Outcome; Young Adult; Antineoplastic Combined Chemotherapy Protocols/therapeutic use
Department(s): Haematology; Radiation Oncology
Publisher's Version: https://doi.org/10.1182/bloodadvances.2026020012
Open Access at Publisher's Site: https://doi.org/10.1182/bloodadvances.2026020012
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-04-28 02:39:58

Last Modified: 2026-09-03 12:44:11