Hodgkin lymphoma in Tyrol-a population-based study

We aimed to analyze the epidemiology, clinical characteristics, and outcome of patients with Hodgkin lymphoma (HL) diagnosed in Tyrol. All patients with newly diagnosed HL between 1993 and 2005 were included in this study. Among the 158 cases included, nodular lymphocytic predominant HL (nodular paragranuloma) was identified in ten cases (6%) whereas the majority of patients had classical Hodgkin lymphoma. Age (p < 0.01), sex (p = 0.03), risk groups according to the German Hodgkin Study Group stratification (p < 0.01), and bone marrow infiltration (p < 0.01) were of prognostic significance considering overall survival (OS) whereas histological subtype and bulky disease were not. The 5- and 10-year OS rates for the total group were 89% and 85%, respectively. Notably, in patients with advanced-stage HL (n = 49), combined modality treatment resulted in significantly better OS than chemotherapy alone (p = 0.01). Three patients developed a second hematological malignancy and one patient developed breast cancer. However, five patients (3%) had a malignant hematological disorder before occurrence of HL. Concerning treatment-related toxicity, bleomycin-associated lung toxicity was observed in six (4%) patients and five (3%) developed lethal treatment-related infectious complications. Our results provide evidence that the incidence rate of HL in Tyrol is comparable to other Western countries. Modern risk-adapted treatment results in excellent long-term prognosis but may be complicated by serious nonhematological side effects, in particular, infections and bleomycin-induced lung toxicity. Furthermore, 3% of HL patients had an antecedent malignant hematological disease before occurrence of HL.