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Year : 2020  |  Volume : 45  |  Issue : 3  |  Page : 148-155

Characteristics of extranodal classic Hodgkin lymphoma: a retrospective analysis of 175 patients

1 Clinical Hematology Unit, Internal Medicine Department, Oncology Center, Mansoura University, Egypt
2 Medical Oncology Unit, Internal Medicine Department, Oncology Center, Mansoura University, Egypt
3 Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
Shaimaa El-Ashwah
Lecturer of Clinical Hematology Unit, Internal Medicine Department, Oncology Center, Mansoura University, Mansoura, 35516
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejh.ejh_9_20

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Aim To find out the characteristics of extranodal classical Hodgkin lymphoma (cHL). Patients and methods A retrospective analysis was done on 175 patients with cHL who attended the Oncology Center of Mansoura University from January 1, 2008 to May 31, 2016, with a median follow-up of 2.93 years (range, 0.05–10.2 years). Results One (0.6%) patient was diagnosed with primary extranodal cHL and 48 (27.4%) patients had secondary extranodal cHL. Liver (25.3%), lung (24.1%), and the bone (20.3%) were the most frequent extranodal sites. A total of 27 (55.1%) patients had one extranodal site, 16 (32.7%) patients had two extranodal sites, and six (12.2%) patients had more than or equal to three sites. Overall, 42 (85.71%) patients with extranodal sites were less than 45 years old (P=0.019), 15 (30.6%) had splenic involvement (P=0.003), 39 (79.6%) patients had absolute monocyte count /absolute lymphocyte count (monocyte-lymphocytes ratio) more than or equal to 0.305 (P<0.001), 36 (73.47%) patients had International Prognostic Score more than or equal to 3 (P<0.001), 23 (46.9%) patients achieved complete response, and 10 (20.4%) patients achieved partial response. In univariate analysis, extranodal disease was associated with inferior disease-free survival and overall survival (P=0.037 and 0.001, respectively), but it lost its significance using multivariate analysis (P=0.12 and 0.54, respectively). Conclusion Most of the extranodal cHL cases were secondary (97.96%) and significantly associated with unfavorable clinical features and lower response rate to standard treatment. To our knowledge, this is the first study to demonstrate that extranodal cHL is statistically associated with elevated monocyte-lymphocytes ratio.

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