Outcome in Hodgkin's disease: A 20-year cohort of patients

We reviewed the long-term survival, treatment-related mortality and morbidi ty of a continuous cohort of patients with Hodgkin's disease diagnosed and staged at the Haematology unit of the Belfast City Hospital between January 1993 and October 1992. The analysis included a comparison of the survival of those patients who were entered into BNLI (British National Lymphoma Inv estigation) trials compared to those not entered during this 20 year period . In addition univariate and multivariate analysis of prognostic factors wa s performed. The complete remission rate (CR) was 79.6% with a 15 year survival of 55.3% . On multivariate analysis in which deaths due to active Hodgkin's disease only were considered age >50 emerged as the most significant prognostic fac tor (P<0.0007), the presence of B symptoms also having independent signific ance (P=0.008). Trial status did not have any independent prognostic signif icance. Eighty one deaths occurred: active Hodgkin's disease (50), second m alignancy (9), treatment-related (10), unrelated (9), unknown (3). This long-term follow up study provides useful information additional to th e data produced by clinical trials which are biased by selection criteria. The occurrence of Haemophilus Influenzae meningitis in a patient 17 years f ollowing splenectomy highlights the need for appropriate vaccination of pat ients splenectomised for Hodgkin's disease.