Hodgkin's disease: A retrospective analysis of 15 years experience at a large referral centre

Background. The prognosis of patients with Hodgkin's disease has improved s ignificantly over the past two decades, primarily as a result of the develo pment of curative combination chemotherapy, However, data on the presentati on and results of treatment in Indian patients are scarce. We reviewed the clinical and pathological data and the treatment outcome of patients with H odgkin's disease seen at our centre over the last 15 years, Methods. The case records of 289 patients diagnosed to have Hodgkin's disea se at our centre between 1977 and 1992 were reviewed, Their clinical charac teristics, treatment outcome and prognostic factors for survival were analy sed. Results. The median age of the patients was 26 years with 30% being in the third decade, The male:female ratio was 4:1, The mixed cellularity histolog ical subtype was the most common (68.5%), followed by nodular sclerosis (8. 9%), 'B' symptoms were present in 73% of patients and 9.4% had bone marrow involvement, At the time of presentation, 70% of patients had advanced dise ase (stage III: 36%, stage IV: 34%), Complete response to treatment was obt ained in 65.7% of patients while 17.3% had partial response. The predictors of decreased overall survival were age > 40 years, presence of 'B' symptom s, lymphocyte depletion histological subtype and stage IV disease. Disease- free survival was Influenced by the presence of 'B' symptoms, bone marrow i nvolvement and stage IV disease. Conclusion. Hodgkin's disease In Indian patients has a distinct clinico-pat hological profile. Combination chemotherapy has high response rates even in patients with advanced disease at presentation.