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We retrospectively investigated histopathological growth patterns in individuals with advanced nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) treated within the randomized HD18 study. In all, 35/60 patients (58%) presented with atypical growth patterns. Patients with atypical growth patterns more often had stage IV disease (P = 0·0354) and splenic involvement (P = 0·0048) than patients with typical growth patterns; a positive positron emission tomography after two cycles of chemotherapy (PET-2) tended to be more common (P = 0·1078). Five-year progression-free survival [hazard ratio (HR) = 0·86; 95% confidence interval (CI) = 0·49–1·47] and overall survival (HR = 0·85; 95% CI = 0·49–1·51) did not differ between the groups after study treatment with PET-2-guided escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone). Thus, advanced NLPHL is often associated with atypical growth patterns but their prognostic impact is compensated by PET-2-guided escalated BEACOPP.
Dennis A. Eichenauer; Ina Bühnen; Stefanie Kreissl; Helen Goergen; Michael Fuchs; Bastian von Tresckow; Andreas Rosenwald; Wolfram Klapper; Martin‐Leo Hansmann; Peter Möller; Heinz‐Wolfram Bernd; Alfred C. Feller; Andreas Engert; Peter Borchmann; Sylvia Hartmann. Histopathological growth patterns in patients with advanced nodular lymphocyte‐predominant Hodgkin lymphoma treated within the randomized HD18 study: a report from the German Hodgkin Study Group. British Journal of Haematology 2021, 1 .
AMA StyleDennis A. Eichenauer, Ina Bühnen, Stefanie Kreissl, Helen Goergen, Michael Fuchs, Bastian von Tresckow, Andreas Rosenwald, Wolfram Klapper, Martin‐Leo Hansmann, Peter Möller, Heinz‐Wolfram Bernd, Alfred C. Feller, Andreas Engert, Peter Borchmann, Sylvia Hartmann. Histopathological growth patterns in patients with advanced nodular lymphocyte‐predominant Hodgkin lymphoma treated within the randomized HD18 study: a report from the German Hodgkin Study Group. British Journal of Haematology. 2021; ():1.
Chicago/Turabian StyleDennis A. Eichenauer; Ina Bühnen; Stefanie Kreissl; Helen Goergen; Michael Fuchs; Bastian von Tresckow; Andreas Rosenwald; Wolfram Klapper; Martin‐Leo Hansmann; Peter Möller; Heinz‐Wolfram Bernd; Alfred C. Feller; Andreas Engert; Peter Borchmann; Sylvia Hartmann. 2021. "Histopathological growth patterns in patients with advanced nodular lymphocyte‐predominant Hodgkin lymphoma treated within the randomized HD18 study: a report from the German Hodgkin Study Group." British Journal of Haematology , no. : 1.
Purpose of review Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare B cell-derived malignancy. This review aims at providing an overview of recent developments in the management of NLPHL. Recent findings Patients with stage IA NLPHL without risk factors have excellent outcomes. The 8-year progression-free survival (PFS) is roughly 90% and the 8-year overall survival (OS) close to 100% after limited-field radiotherapy (RT) alone. Individuals presenting with early stages other than stage IA without risk factors and intermediate stages have 10-year PFS rates in excess of 70% and 10-year OS rates exceeding 90% when treated with 2 and 4 cycles of ABVD, respectively, followed by consolidation RT. In advanced NLPHL, different protocols such as BEACOPP, ABVD, and R-CHOP have been evaluated retrospectively. However, the optimal approach is undefined. Patients with relapsed NLPHL mostly receive single-agent anti-CD20 antibody treatment or conventional chemotherapy. High-dose chemotherapy and autologous stem cell transplantation are restricted to high-risk patients. NLPHL recurrence is salvaged successfully in the majority of cases. Summary Patients with NLPHL have a very good prognosis. Treatment differs from classical Hodgkin lymphoma in some situations.
Dennis A. Eichenauer; Andreas Engert. Current treatment options for nodular lymphocyte-predominant Hodgkin lymphoma. Current Opinion in Oncology 2021, 33, 395 -399.
AMA StyleDennis A. Eichenauer, Andreas Engert. Current treatment options for nodular lymphocyte-predominant Hodgkin lymphoma. Current Opinion in Oncology. 2021; 33 (5):395-399.
Chicago/Turabian StyleDennis A. Eichenauer; Andreas Engert. 2021. "Current treatment options for nodular lymphocyte-predominant Hodgkin lymphoma." Current Opinion in Oncology 33, no. 5: 395-399.
Hodgkin lymphoma (HL) is a rare malignancy accounting for roughly 15% of all lymphomas and mostly affecting young patients. A second peak is seen in patients above 60 years of age. The history of HL treatment represents a remarkable success story in which HL has turned from an incurable disease to a neoplasm with an excellent prognosis. First-line treatment with stage-adapted treatment consisting of chemotherapy and/or radiotherapy results in cure rates of approximately 80%. Second-line treatment mostly consists of intensive salvage chemotherapy followed by high-dose chemotherapy (HDCT) and autologous stem cell transplantation (ASCT). Novel approaches such as antibody drug conjugates and immunomodulatory drugs have shown impressive results in clinical trials in refractory and relapsed HL and are now increasingly implemented in earlier treatment lines. This review gives a comprehensive overview on HL addressing epidemiology, pathophysiology and current treatment options as well as recent developments and perspectives.
Jesko Momotow; Sven Borchmann; Dennis Eichenauer; Andreas Engert; Stephanie Sasse. Hodgkin Lymphoma—Review on Pathogenesis, Diagnosis, Current and Future Treatment Approaches for Adult Patients. Journal of Clinical Medicine 2021, 10, 1125 .
AMA StyleJesko Momotow, Sven Borchmann, Dennis Eichenauer, Andreas Engert, Stephanie Sasse. Hodgkin Lymphoma—Review on Pathogenesis, Diagnosis, Current and Future Treatment Approaches for Adult Patients. Journal of Clinical Medicine. 2021; 10 (5):1125.
Chicago/Turabian StyleJesko Momotow; Sven Borchmann; Dennis Eichenauer; Andreas Engert; Stephanie Sasse. 2021. "Hodgkin Lymphoma—Review on Pathogenesis, Diagnosis, Current and Future Treatment Approaches for Adult Patients." Journal of Clinical Medicine 10, no. 5: 1125.
D.A. Eichenauer; S. Kreissl; I. Bühnen; C. Baues; C. Kobe; L. van Heek; H. Goergen; M. Fuchs; S. Hartmann; B. von Tresckow; A. Engert; P. Borchmann. PET-2-guided escalated BEACOPP for advanced nodular lymphocyte-predominant Hodgkin lymphoma: a subgroup analysis of the randomized German Hodgkin Study Group HD18 study. Annals of Oncology 2021, 32, 807 -810.
AMA StyleD.A. Eichenauer, S. Kreissl, I. Bühnen, C. Baues, C. Kobe, L. van Heek, H. Goergen, M. Fuchs, S. Hartmann, B. von Tresckow, A. Engert, P. Borchmann. PET-2-guided escalated BEACOPP for advanced nodular lymphocyte-predominant Hodgkin lymphoma: a subgroup analysis of the randomized German Hodgkin Study Group HD18 study. Annals of Oncology. 2021; 32 (6):807-810.
Chicago/Turabian StyleD.A. Eichenauer; S. Kreissl; I. Bühnen; C. Baues; C. Kobe; L. van Heek; H. Goergen; M. Fuchs; S. Hartmann; B. von Tresckow; A. Engert; P. Borchmann. 2021. "PET-2-guided escalated BEACOPP for advanced nodular lymphocyte-predominant Hodgkin lymphoma: a subgroup analysis of the randomized German Hodgkin Study Group HD18 study." Annals of Oncology 32, no. 6: 807-810.
Bei der hämophagozytischen Lymphohistiozytose (HLH) handelt es sich um ein Hyperinflammationssyndrom bedingt durch aberrant aktivierte Makrophagen und T‑Zellen. Beim Erwachsenen ist in erster Linie die erworbene Form anzutreffen. Häufige Auslöser sind Infektionen, Malignome und Autoimmunerkrankungen. Zuletzt wurden zudem zunehmend Fälle berichtet, in denen das Auftreten im Zusammenhang mit stattgehabten Immuntherapien zu sehen war. Auf der Intensivstation ist die HLH aufgrund des ähnlichen klinischen Erscheinungsbilds oft schwer von der Sepsis abzugrenzen. Zum Teil liegen beide zeitgleich vor. Die frühzeitige Diagnosestellung und Einleitung einer adäquaten immunsuppressiven Therapie ist für den weiteren Verlauf und die Prognose der HLH essenziell. Deshalb muss bei kritisch kranken Patienten mit persistierendem Fieber und entsprechenden Symptomen (z. B. Splenomegalie, neurologische Auffälligkeiten) oder Laborveränderungen (z. B. erhöhter Ferritinwert, Zytopenie von 2 oder 3 Zellreihen, erhöhte Transaminasen) das Vorliegen einer HLH in Betracht gezogen werden. Die Diagnose wird mithilfe der HLH-2004-Kriterien gestellt. Mit dem HScore kann die Wahrscheinlichkeit des Vorliegens einer HLH berechnet werden. Hochdosierte Kortikosteroide stellen den Grundpfeiler der HLH-Therapie dar. Je nach Auslöser werden Etoposid, Immunglobuline, Anakinra oder weitere Medikamente ergänzt. Der Verlauf hängt neben einem frühzeitigen Behandlungsbeginn vom Auslöser sowie dem Ansprechen auf die Therapie ab. Insgesamt ist die Prognose der HLH trotz maximaler intensivmedizinischer Behandlung ungünstig und sie ist mit einer hohen Letalität assoziiert.
D. A. Eichenauer; G. Lachmann; P. La Rosée. Die hämophagozytische Lymphohistiozytose bei kritisch kranken Patienten. Medizinische Klinik - Intensivmedizin und Notfallmedizin 2021, 116, 129 -134.
AMA StyleD. A. Eichenauer, G. Lachmann, P. La Rosée. Die hämophagozytische Lymphohistiozytose bei kritisch kranken Patienten. Medizinische Klinik - Intensivmedizin und Notfallmedizin. 2021; 116 (2):129-134.
Chicago/Turabian StyleD. A. Eichenauer; G. Lachmann; P. La Rosée. 2021. "Die hämophagozytische Lymphohistiozytose bei kritisch kranken Patienten." Medizinische Klinik - Intensivmedizin und Notfallmedizin 116, no. 2: 129-134.
Data on non‐Hodgkin lymphoma (NHL) after classical Hodgkin lymphoma (cHL) are scarce. We therefore performed a retrospective analysis comprising 11·841 cHL patients who had first‐line treatment within the randomized German Hodgkin Study Group (GHSG) HD7–HD15 studies. After a median follow‐up of 106 months, 175 patients (1·5%) had developed NHL. The median time to NHL was 44 months, the median age at NHL diagnosis was 54 years. The five‐year event‐free survival and overall survival estimates from the diagnosis of NHL were 36·9% and 44·2%, respectively. Thus, NHL after cHL is a rare event primarily affecting older individuals and often resulting in the patient´s death.
Dennis A. Eichenauer; Horst Müller; Leonard Elger; Helen Goergen; Michael Fuchs; Stefanie Kreissl; Boris Böll; Volker Diehl; Bastian von Tresckow; Peter Borchmann; Andreas Engert. Non‐Hodgkin lymphoma after treatment for classical Hodgkin lymphoma: a report from the German Hodgkin Study Group. British Journal of Haematology 2021, 193, 515 -519.
AMA StyleDennis A. Eichenauer, Horst Müller, Leonard Elger, Helen Goergen, Michael Fuchs, Stefanie Kreissl, Boris Böll, Volker Diehl, Bastian von Tresckow, Peter Borchmann, Andreas Engert. Non‐Hodgkin lymphoma after treatment for classical Hodgkin lymphoma: a report from the German Hodgkin Study Group. British Journal of Haematology. 2021; 193 (3):515-519.
Chicago/Turabian StyleDennis A. Eichenauer; Horst Müller; Leonard Elger; Helen Goergen; Michael Fuchs; Stefanie Kreissl; Boris Böll; Volker Diehl; Bastian von Tresckow; Peter Borchmann; Andreas Engert. 2021. "Non‐Hodgkin lymphoma after treatment for classical Hodgkin lymphoma: a report from the German Hodgkin Study Group." British Journal of Haematology 193, no. 3: 515-519.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity with distinct pathologic and clinical characteristics. Unlike the malignant cells in classical Hodgkin lymphoma, the disease-defining lymphocyte-predominant cells in NLPHL are consistently positive for CD20, but do not express CD30. The clinical course of NLPHL is indolent in the majority of cases. Most patients present with early-stage disease at the initial diagnosis. First-line treatment of stage IA NLPHL usually consists of limited-field radiotherapy alone. Patients with early-stage NLPHL other than stage IA and intermediate-stage disease mostly receive combined-modality treatment, whereas individuals with advanced NLPHL are treated with chemotherapy alone. In relapsed NLPHL, conventional chemotherapy, anti-CD20 antibodies, and radiotherapy represent active treatment modalities. Only patients with poor-risk characteristics such as early disease recurrence are candidates for aggressive salvage treatment with high-dose chemotherapy and autologous stem cell transplantation. The overall and relative survival of patients with NLPHL is excellent as indicated by a low excess mortality compared with the general population. This article discusses treatment options for patients with NLPHL and factors that influence the choice of therapy on the basis of the available data and 2 clinical cases.
Dennis A. Eichenauer; Andreas Engert. How I treat nodular lymphocyte-predominant Hodgkin lymphoma. Blood 2020, 136, 2987 -2993.
AMA StyleDennis A. Eichenauer, Andreas Engert. How I treat nodular lymphocyte-predominant Hodgkin lymphoma. Blood. 2020; 136 (26):2987-2993.
Chicago/Turabian StyleDennis A. Eichenauer; Andreas Engert. 2020. "How I treat nodular lymphocyte-predominant Hodgkin lymphoma." Blood 136, no. 26: 2987-2993.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a global health emergency. To improve the understanding of the systemic component of SARS-CoV-2, we investigated if viral load dynamics in plasma and respiratory samples are associated with antibody response and severity of coronavirus disease 2019 (COVID-19). SARS-CoV-2 RNA was found in plasma samples from 14 (44%) out of 32 patients. RNAemia was detected in 5 out of 6 fatal cases. Peak IgG values were significantly lower in mild/moderate than in severe (0.6 (interquartile range, IQR, 0.4–3.2) vs. 11.8 (IQR, 9.9–13.0), adjusted p = 0.003) or critical cases (11.29 (IQR, 8.3–12.0), adjusted p = 0.042). IgG titers were significantly associated with virus Ct (Cycle threshold) value in plasma and respiratory specimens ((ß = 0.4, 95% CI (confidence interval, 0.2; 0.5), p < 0.001 and ß = 0.5, 95% CI (0.2; 0.6), p = 0.002). A classification as severe or a critical case was additionally inversely associated with Ct values in plasma in comparison to mild/moderate cases (ß = −3.3, 95% CI (−5.8; 0.8), p = 0.024 and ß = −4.4, 95% CI (−7.2; 1.6), p = 0.007, respectively). Based on the present data, our hypothesis is that the early stage of SARS-CoV-2 infection is characterized by a primary RNAemia, as a potential manifestation of a systemic infection. Additionally, the viral load in plasma seems to be associated with a worse disease outcome.
Kirsten Alexandra Eberhardt; Charlotte Meyer-Schwickerath; Eva Heger; Elena Knops; Clara Lehmann; Jan Rybniker; Philipp Schommers; Dennis A. Eichenauer; Florian Kurth; Michael Ramharter; Rolf Kaiser; Udo Holtick; Florian Klein; Norma Jung; Veronica Di Cristanziano. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses 2020, 12, 1045 .
AMA StyleKirsten Alexandra Eberhardt, Charlotte Meyer-Schwickerath, Eva Heger, Elena Knops, Clara Lehmann, Jan Rybniker, Philipp Schommers, Dennis A. Eichenauer, Florian Kurth, Michael Ramharter, Rolf Kaiser, Udo Holtick, Florian Klein, Norma Jung, Veronica Di Cristanziano. RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients. Viruses. 2020; 12 (9):1045.
Chicago/Turabian StyleKirsten Alexandra Eberhardt; Charlotte Meyer-Schwickerath; Eva Heger; Elena Knops; Clara Lehmann; Jan Rybniker; Philipp Schommers; Dennis A. Eichenauer; Florian Kurth; Michael Ramharter; Rolf Kaiser; Udo Holtick; Florian Klein; Norma Jung; Veronica Di Cristanziano. 2020. "RNAemia Corresponds to Disease Severity and Antibody Response in Hospitalized COVID-19 Patients." Viruses 12, no. 9: 1045.
Objectives Patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications like invasive aspergillosis. Our study evaluates Coronavirus disease 19 (COVID‐19) associated invasive aspergillosis at a single center in Cologne, Germany. Methods A retrospective chart review of all patients with COVID‐19 ARDS admitted to the medical or surgical intensive care unit at the University Hospital of Cologne, Germany. Results COVID‐19 associated invasive pulmonary aspergillosis was found in five of 19 consecutive critically ill patients with moderate to severe ARDS. Conclusion Clinicians caring for patients with ARDS due to COVID‐19 should consider invasive pulmonary aspergillosis and subject respiratory samples to comprehensive analysis to detect co‐infection.
Philipp Koehler; Oliver A. Cornely; Bernd W. Böttiger; Fabian Dusse; Dennis A. Eichenauer; Frieder Fuchs; Michael Hallek; Norma Jung; Florian Klein; Thorsten Persigehl; Jan Rybniker; Matthias Kochanek; Boris Böll; Alexander Shimabukuro‐Vornhagen. COVID‐19 associated pulmonary aspergillosis. Mycoses 2020, 63, 528 -534.
AMA StylePhilipp Koehler, Oliver A. Cornely, Bernd W. Böttiger, Fabian Dusse, Dennis A. Eichenauer, Frieder Fuchs, Michael Hallek, Norma Jung, Florian Klein, Thorsten Persigehl, Jan Rybniker, Matthias Kochanek, Boris Böll, Alexander Shimabukuro‐Vornhagen. COVID‐19 associated pulmonary aspergillosis. Mycoses. 2020; 63 (6):528-534.
Chicago/Turabian StylePhilipp Koehler; Oliver A. Cornely; Bernd W. Böttiger; Fabian Dusse; Dennis A. Eichenauer; Frieder Fuchs; Michael Hallek; Norma Jung; Florian Klein; Thorsten Persigehl; Jan Rybniker; Matthias Kochanek; Boris Böll; Alexander Shimabukuro‐Vornhagen. 2020. "COVID‐19 associated pulmonary aspergillosis." Mycoses 63, no. 6: 528-534.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity representing about 5% of all HL cases. Pathobiology and clinical course differ from classical HL (cHL). This chapter describes the pathologic and clinical characteristics, differential diagnoses, risk factors, and treatment options of NLPHL.
Dennis A. Eichenauer; Ranjana H. Advani. Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Hematologic Malignancies 2020, 317 -324.
AMA StyleDennis A. Eichenauer, Ranjana H. Advani. Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Hematologic Malignancies. 2020; ():317-324.
Chicago/Turabian StyleDennis A. Eichenauer; Ranjana H. Advani. 2020. "Nodular Lymphocyte-Predominant Hodgkin Lymphoma." Hematologic Malignancies , no. : 317-324.
Summary Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is an unusual subtype of Hodgkin lymphoma characterised by a distinct histopathological and clinical presentation. It mostly affects males and presents with localised disease and an indolent clinical course in the majority of cases. However, there are also patients with advanced NLPHL who frequently present with spleen and liver involvement, B-symptoms and a more aggressive clinical course. Different clinical presentations correlate with distinct histopathological characteristics. NLPHL can be divided into typical and variant histopathological growth patterns. The clinical course of most patients with a typical growth pattern is indolent whereas patients with a variant histology more often present with advanced stage disease and relapse occurs more frequently and earlier. Despite these differences, the prognosis after stage-adapted treatment is favourable for both patient groups. Some cases presenting with a variant histology show a histopathological and clinical overlap with T-cell/histiocyte rich large B-cell lymphoma (THRLBCL). Although being considered as aggressive B-cell lymphoma, THRLBCL exhibits many features that are similar to NLPHL, indicating a close relationship with regard to pathogenesis. Both lymphoma entities derive from germinal centre B-cells, show ongoing somatic hypermutation, and resemble each other in terms of gene expression of tumour cells, genomic imbalances and mutation patterns.
Sylvia Hartmann; Dennis A. Eichenauer. Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma. Pathology 2019, 52, 142 -153.
AMA StyleSylvia Hartmann, Dennis A. Eichenauer. Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma. Pathology. 2019; 52 (1):142-153.
Chicago/Turabian StyleSylvia Hartmann; Dennis A. Eichenauer. 2019. "Nodular lymphocyte predominant Hodgkin lymphoma: pathology, clinical course and relation to T-cell/histiocyte rich large B-cell lymphoma." Pathology 52, no. 1: 142-153.
Dennis A. Eichenauer; Heidrun Golla; Indra Thielen; Michael Hallek; Raymond Voltz; Klaus Maria Perrar. Characteristics and course of patients with advanced hematologic malignancies receiving specialized inpatient palliative care at a German university hospital. Annals of Hematology 2019, 98, 2605 -2607.
AMA StyleDennis A. Eichenauer, Heidrun Golla, Indra Thielen, Michael Hallek, Raymond Voltz, Klaus Maria Perrar. Characteristics and course of patients with advanced hematologic malignancies receiving specialized inpatient palliative care at a German university hospital. Annals of Hematology. 2019; 98 (11):2605-2607.
Chicago/Turabian StyleDennis A. Eichenauer; Heidrun Golla; Indra Thielen; Michael Hallek; Raymond Voltz; Klaus Maria Perrar. 2019. "Characteristics and course of patients with advanced hematologic malignancies receiving specialized inpatient palliative care at a German university hospital." Annals of Hematology 98, no. 11: 2605-2607.
Key Points Patients with relapsed or refractory NLPHL have a favorable overall prognosis. Treatment of relapsed or refractory NLPHL should be chosen individually.
Dennis A. Eichenauer; Annette Plütschow; Lena Schröder; Michael Fuchs; Boris Böll; Bastian Von Tresckow; Volker Diehl; Peter Borchmann; Andreas Engert. Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group. Blood 2018, 132, 1519 -1525.
AMA StyleDennis A. Eichenauer, Annette Plütschow, Lena Schröder, Michael Fuchs, Boris Böll, Bastian Von Tresckow, Volker Diehl, Peter Borchmann, Andreas Engert. Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group. Blood. 2018; 132 (14):1519-1525.
Chicago/Turabian StyleDennis A. Eichenauer; Annette Plütschow; Lena Schröder; Michael Fuchs; Boris Böll; Bastian Von Tresckow; Volker Diehl; Peter Borchmann; Andreas Engert. 2018. "Relapsed and refractory nodular lymphocyte-predominant Hodgkin lymphoma: an analysis from the German Hodgkin Study Group." Blood 132, no. 14: 1519-1525.
Purpose The prognostic effect of isolated infradiaphragmatic involvement in Hodgkin lymphoma (HL) is controversial, and there are little data about patients treated with current therapies. Therefore, we performed a risk factor analysis to focus on isolated nodal infradiaphragmatic disease in patients treated within the German Hodgkin Study Group trials HD13 (clinical trial information: ISRCTN63474366) and HD14 (clinical trial information: ISRCTN04761296) for early-stage HL. Patients and Methods Characteristics and outcomes of patients who had infradiaphragmatic HL were compared with patients who had supradiaphragmatic disease. Progression-free survival (PFS) and overall survival (OS) were estimated according to Kaplan-Meier methods and were compared between groups using the log-rank test and Cox proportional hazards regression, which was also applied for multivariable analyses that adjusted for relevant baseline characteristics. Results Of 2,903 qualified patients, 223 (7.7%) were diagnosed with isolated nodal infradiaphragmatic disease. In general, these patients were older, had a poorer performance status, were more often male, and had the nodular sclerosis subtype less often than those with supradiaphragmatic disease. After a median follow-up time of 51 months, PFS and OS were significantly worse in patients with infradiaphragmatic disease (5-year PFS and OS, 80.1% and 91.5% v 91.2% and 97.6% in patients with supradiaphragmatic disease; each P < .001). In multivariable analyses, infradiaphragmatic HL remained a significant risk factor in terms of PFS (hazard ratio [HR], 1.5; 95% CI, 1.04 to 2.2; P = .03) and OS (HR, 2.0; 95% CI, 1.2 to 3.5; P = .01). However, inferior PFS and OS could not be observed among those patients treated with the more intensive chemotherapy (two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine [ABVD] in HD13, and two cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone [BEACOPPescalated] plus two cycles of ABVD in HD14; all patients received 30 Gy of involved-field radiotherapy). Conclusion Early-stage HL that presents with infradiaphragmatic disease only represents a distinct patient group with an inferior outcome. However, this adverse outcome can be outweighed by appropriate combined modality treatment.
Stephanie Sasse; Helen Goergen; Annette Plütschow; Boris Böll; Dennis A. Eichenauer; Michael Fuchs; Karolin Behringer; Joseé M. Zijlstra; Richard Greil; Jana Markova; Max S. Topp; Julia Meissner; Andreas Neubauer; Christian Baues; Andreas Engert; Peter Borchmann; Bastian Von Tresckow. Outcome of Patients With Early-Stage Infradiaphragmatic Hodgkin Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group. Journal of Clinical Oncology 2018, 36, 2603 -2611.
AMA StyleStephanie Sasse, Helen Goergen, Annette Plütschow, Boris Böll, Dennis A. Eichenauer, Michael Fuchs, Karolin Behringer, Joseé M. Zijlstra, Richard Greil, Jana Markova, Max S. Topp, Julia Meissner, Andreas Neubauer, Christian Baues, Andreas Engert, Peter Borchmann, Bastian Von Tresckow. Outcome of Patients With Early-Stage Infradiaphragmatic Hodgkin Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group. Journal of Clinical Oncology. 2018; 36 (25):2603-2611.
Chicago/Turabian StyleStephanie Sasse; Helen Goergen; Annette Plütschow; Boris Böll; Dennis A. Eichenauer; Michael Fuchs; Karolin Behringer; Joseé M. Zijlstra; Richard Greil; Jana Markova; Max S. Topp; Julia Meissner; Andreas Neubauer; Christian Baues; Andreas Engert; Peter Borchmann; Bastian Von Tresckow. 2018. "Outcome of Patients With Early-Stage Infradiaphragmatic Hodgkin Lymphoma: A Comprehensive Analysis From the German Hodgkin Study Group." Journal of Clinical Oncology 36, no. 25: 2603-2611.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity with an incidence of 0.1 to 0.2/100 000/y. Compared with the more common subtypes of classical Hodgkin lymphoma, NLPHL is characterized by distinct pathological and clinical features. Histologically, the disease-defining lymphocyte predominant cells consistently express CD20 but lack CD30. Clinically, NLPHL mostly has a rather indolent course, and patients usually are diagnosed in early stages. The prognosis of early-stage NLPHL is excellent, with progression-free survival and overall survival rates exceeding 90% after involved-field radiotherapy (IF-RT) alone (stage IA) or combined modality treatment consisting of a brief chemotherapy with 2 cycles of ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) chemotherapy followed by IF-RT (early stages other than stage IA). In contrast, patients with advanced disease at diagnosis tend to relapse either with NLPHL histology or with histological transformation into aggressive B-cell non-Hodgkin lymphoma despite more aggressive first-line treatment with 6 to 8 cycles of multiagent chemotherapy. However, even NLPHL patients with multiple relapses successfully respond to salvage therapy in many cases. Salvage therapies range from single-agent anti-CD20 antibody treatment to high-dose chemotherapy followed by autologous stem cell transplantation. Treatment at disease recurrence should be chosen on the basis of various factors, including histology at relapse, time to relapse, extent of disease at relapse, and prior treatment. Because death among NLPHL patients is more often caused by therapy-related late effects than lymphoma-related complications, optimizing the risk-benefit ratio of treatment by decreasing toxicity whenever possible is the major goal of clinical research in this disease.
Dennis A. Eichenauer; Andreas Engert. Nodular lymphocyte-predominant Hodgkin lymphoma: a unique disease deserving unique management. Hematology 2017, 2017, 324 -328.
AMA StyleDennis A. Eichenauer, Andreas Engert. Nodular lymphocyte-predominant Hodgkin lymphoma: a unique disease deserving unique management. Hematology. 2017; 2017 (1):324-328.
Chicago/Turabian StyleDennis A. Eichenauer; Andreas Engert. 2017. "Nodular lymphocyte-predominant Hodgkin lymphoma: a unique disease deserving unique management." Hematology 2017, no. 1: 324-328.
Bastian Von Tresckow; Franck Morschhauser; Jeffrey Szer; Dennis A. Eichenauer; Jeremy S. Abramson; Anna Sureda; Andreas Engert. Panobinostat consolidation in patients with Hodgkin lymphoma at risk for relapse after high dose chemotherapy and autologous stem cell transplant: final results after early trial discontinuation. Leukemia & Lymphoma 2016, 58, 1 -4.
AMA StyleBastian Von Tresckow, Franck Morschhauser, Jeffrey Szer, Dennis A. Eichenauer, Jeremy S. Abramson, Anna Sureda, Andreas Engert. Panobinostat consolidation in patients with Hodgkin lymphoma at risk for relapse after high dose chemotherapy and autologous stem cell transplant: final results after early trial discontinuation. Leukemia & Lymphoma. 2016; 58 (1):1-4.
Chicago/Turabian StyleBastian Von Tresckow; Franck Morschhauser; Jeffrey Szer; Dennis A. Eichenauer; Jeremy S. Abramson; Anna Sureda; Andreas Engert. 2016. "Panobinostat consolidation in patients with Hodgkin lymphoma at risk for relapse after high dose chemotherapy and autologous stem cell transplant: final results after early trial discontinuation." Leukemia & Lymphoma 58, no. 1: 1-4.
Key Points Two cycles of ABVD or AVD were equally tolerable in older early-stage favorable HL patients. Excessive toxicity including severe bleomycin-induced lung toxicity occurred in older HL patients receiving 4 cycles of ABVD.
Boris Böll; Helen Goergen; Karolin Behringer; Paul J. Bröckelmann; Felicitas Hitz; Andrea Kerkhoff; Richard Greil; Bastian Von Tresckow; Dennis A. Eichenauer; Carolin Bürkle; Sven Borchmann; Michael Fuchs; Volker Diehl; Andreas Engert; Peter Borchmann. Bleomycin in older early-stage favorable Hodgkin lymphoma patients: analysis of the German Hodgkin Study Group (GHSG) HD10 and HD13 trials. Blood 2016, 127, 2189 -2192.
AMA StyleBoris Böll, Helen Goergen, Karolin Behringer, Paul J. Bröckelmann, Felicitas Hitz, Andrea Kerkhoff, Richard Greil, Bastian Von Tresckow, Dennis A. Eichenauer, Carolin Bürkle, Sven Borchmann, Michael Fuchs, Volker Diehl, Andreas Engert, Peter Borchmann. Bleomycin in older early-stage favorable Hodgkin lymphoma patients: analysis of the German Hodgkin Study Group (GHSG) HD10 and HD13 trials. Blood. 2016; 127 (18):2189-2192.
Chicago/Turabian StyleBoris Böll; Helen Goergen; Karolin Behringer; Paul J. Bröckelmann; Felicitas Hitz; Andrea Kerkhoff; Richard Greil; Bastian Von Tresckow; Dennis A. Eichenauer; Carolin Bürkle; Sven Borchmann; Michael Fuchs; Volker Diehl; Andreas Engert; Peter Borchmann. 2016. "Bleomycin in older early-stage favorable Hodgkin lymphoma patients: analysis of the German Hodgkin Study Group (GHSG) HD10 and HD13 trials." Blood 127, no. 18: 2189-2192.
Accurate clinical staging is crucial for adequate risk‐adapted treatment in Hodgkin lymphoma (HL) to prevent patients from under‐ or over‐treatment. Within the latest German Hodgkin Study Group trial generation, diagnostic findings such as histopathology, computerized tomography imaging and clinical risk factors were re‐evaluated by expert panels. Here, we retrospectively analysed 5965 patients and identified 399 in who major discordant findings changed their first‐line treatment allocation. Histopathology review did not confirm the initial diagnosis of HL in 87 patients. Treatment allocation was revised in 312 of the remaining 5878 patients: 176 were assigned to a higher and 128 to a lower risk group, respectively; the correct treatment group remained unclear in 8 patients. Cases of revised treatment allocation accounted for 9·8%, 6·0%, 0·8%, and 14·8% of patients initially assigned to the HD13, HD14, HD15 trials and stage IA lymphocyte‐predominant HL project, respectively. Most revisions were due to wrong application of clinical stage (20·5% of 312 patients with revised treatment group), histological subtype (9·0%) or the risk factors ≥3 involved areas (46·8%) or large mediastinal mass (9·3%). In conclusion, centralized review by experienced experts changed risk‐adapted first‐line treatment in a relevant proportion of HL patients. Quality control measures clearly improve the accuracy of treatment and should be implemented in clinical practice.
Paul J. Bröckelmann; Helen Goergen; Michael Fuchs; Jan Kriz; Robert Semrau; Christian Baues; Carsten Kobe; Karolin Behringer; Dennis A. Eichenauer; Bastian Von Tresckow; Beate Klimm; Teresa Halbsguth; Diana Wongso; Annette Plütschow; Heinz Haverkamp; Markus Dietlein; Hans T. Eich; Harald Stein; Volker Diehl; Peter Borchmann; Andreas Engert. Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group. British Journal of Haematology 2015, 171, 547 -556.
AMA StylePaul J. Bröckelmann, Helen Goergen, Michael Fuchs, Jan Kriz, Robert Semrau, Christian Baues, Carsten Kobe, Karolin Behringer, Dennis A. Eichenauer, Bastian Von Tresckow, Beate Klimm, Teresa Halbsguth, Diana Wongso, Annette Plütschow, Heinz Haverkamp, Markus Dietlein, Hans T. Eich, Harald Stein, Volker Diehl, Peter Borchmann, Andreas Engert. Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group. British Journal of Haematology. 2015; 171 (4):547-556.
Chicago/Turabian StylePaul J. Bröckelmann; Helen Goergen; Michael Fuchs; Jan Kriz; Robert Semrau; Christian Baues; Carsten Kobe; Karolin Behringer; Dennis A. Eichenauer; Bastian Von Tresckow; Beate Klimm; Teresa Halbsguth; Diana Wongso; Annette Plütschow; Heinz Haverkamp; Markus Dietlein; Hans T. Eich; Harald Stein; Volker Diehl; Peter Borchmann; Andreas Engert. 2015. "Impact of centralized diagnostic review on quality of initial staging in Hodgkin lymphoma: experience of the German Hodgkin Study Group." British Journal of Haematology 171, no. 4: 547-556.
Dennis A. Eichenauer; Andreas Engert. What Is the Role of Rituximab in Nodular Lymphocyte-Predominant Hodgkin Lymphoma? Acta Haematologica 2015, 134, 185 -6.
AMA StyleDennis A. Eichenauer, Andreas Engert. What Is the Role of Rituximab in Nodular Lymphocyte-Predominant Hodgkin Lymphoma? Acta Haematologica. 2015; 134 (3):185-6.
Chicago/Turabian StyleDennis A. Eichenauer; Andreas Engert. 2015. "What Is the Role of Rituximab in Nodular Lymphocyte-Predominant Hodgkin Lymphoma?" Acta Haematologica 134, no. 3: 185-6.
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is a rare lymphoma entity representing about 5 % of all HL cases. Pathobiology and clinical course substantially differ from classical HL (cHL). This chapter describes the pathologic and clinical characteristics, differential diagnoses, risk factors, and treatment options of NLPHL.
Dennis A. Eichenauer; Michelle A. Fanale. Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Hematologic Malignancies 2014, 287 -295.
AMA StyleDennis A. Eichenauer, Michelle A. Fanale. Nodular Lymphocyte-Predominant Hodgkin Lymphoma. Hematologic Malignancies. 2014; ():287-295.
Chicago/Turabian StyleDennis A. Eichenauer; Michelle A. Fanale. 2014. "Nodular Lymphocyte-Predominant Hodgkin Lymphoma." Hematologic Malignancies , no. : 287-295.