Prognostic Factors of Hodgkin's Disease Recurrence: An Experience From a Tertiary Academic Center in Iran

Introduction Despite the favorable prognosis of Hodgkin's disease (HD), some patients experience disease recurrence. Therefore, determining recurrence prognostic factors is very crucial to identify patients at risk of early relapse, maintain remission, and improve outcomes. Materials and methods This retrospective cohort study enrolled HD patients at the National Research Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital, between January 1, 2002, and June 30, 2018. Demographic characteristics and clinical outcomes, including response to treatment, disease progression, and survival data, were considered. Results Two hundred fifty patients were enrolled. The mean age at diagnosis was 30.03 years. The female-to-male ratio was 1.06:1. Eighty-five (34%) disease recurrences occurred within the study period, most occurring before three years of initial diagnosis. The mean of progression-free survival (PFS) was 18.4 months. In both univariate and multivariate analyses, the advanced stage (stage IV) was significantly associated with shorter PFS (P=0.0001 and P=0.004, respectively). Also, shorter PFS was observed in the presence of bulky tumors (P=0.037/univariate analysis) and high-risk International Prognostic Score (IPS) (P=0.030/multivariate analysis). Conclusion Our findings in the Iranian HD patient cohort revealed that the risk of disease recurrence is higher in the presence of some clinical characteristics such as bulky disease, higher IPS, and advanced stage which needs special attention. Close follow-up, especially within three years after initial diagnosis, has a great importance to detect early relapse.