Summary
This was a retrospective observational study. We identified newly diagnosed CHL cases between 1/1/2016 and 7/31/2021 from the ConcertAI Oncology Dataset which includes electronic medical records drawn from oncology clinics with 80% community vs 20% academic coverage across the US. All eligible patients were ≥18 years and required to have documented disease stage at initial CHL diagnosis. Patients were categorized as early favorable (stage I/II with no unfavorable factor), early unfavorable (stage I/II with any unfavorable factors), or advanced stage (stage III/IV) according to National Comprehensive Cancer Network (NCCN) guidelines.
Methods
This was a retrospective observational study. We identified newly diagnosed CHL cases between 1/1/2016 and 7/31/2021 from the ConcertAI Oncology Dataset which includes electronic medical records drawn from oncology clinics with 80% community vs 20% academic coverage across the US. All eligible patients were ≥18 years and required to have documented disease stage at initial CHL diagnosis. Patients were categorized as early favorable (stage I/II with no unfavorable factor), early unfavorable (stage I/II with any unfavorable factors), or advanced stage (stage III/IV) according to National Comprehensive Cancer Network (NCCN) guidelines.
Results
Of the total 324 patients who met eligibility criteria, over half of the cohort (n=166, 51.2%) was diagnosed with advanced CHL while 16.1% and 32.7% had early favorable and early unfavorable CHL, respectively. Patients with early unfavorable CHL were younger than their counterparts (median age 53.8 vs 34.8 early unfavorable vs 46.6 years advanced). The proportion of patients with stage II disease was higher in the early unfavorable cohort compared with the early favorable cohort (87.7% vs 69.2%). Patients with early unfavorable CHL had a larger nodal mass (mean 5.9 cm vs 5.3 cm advanced vs 4.4 cm early favorable). The percentages of patients with B symptoms (59.4%), bulky disease (46.2%), >3 involved lymph node regions (31.1%), and ESR ≥ 50 (25.5%) were higher in patients with early unfavorable CHL compared to other two groups. The primary treatment after initial diagnosis for early unfavorable CHL was bleomycin, dacarbazine, doxorubicin, vinblastine (ABVD) regimen (68.9%).
Conclusions
In this analysis of real-world data, we found that nearly one-third of newly diagnosed CHL patients had early unfavorable disease. Our analysis also showed differences in the magnitude of the proportion of patients for each unfavorable factor among patients with early-stage unfavorable CHL.
