Clinical Characteristics, Treatment Outcomes, and Prognostic  Factors in Hodgkin Lymphoma: A Retrospective Cohort Study  at King Khalid Hospital, Najran

Ahmed M. Badheeb; Hasan Salem Al Greshah; Musadag Elhadi; Nasher H Alyami; Abdelaziz Aman; Islam A Seada; Abdullah Abu Bakar; Samer Alkarak; Mohammed S Bazuqamah; Mahran Mohammed; Ammar Idris; Faisal Ahmed; Mohamed Badheeb

doi:10.31557/apjcc.2026.11.2.169-177

Authors

Ahmed M. Badheeb Oncology, King Khalid Hospital - Oncology Center, Najran, Saudi Arabia.
Hasan Salem Al Greshah Hematology, King Khalid Hospital, Najran, Saudi Arabia.
Musadag Elhadi Internal Medicine, King Khalid Hospital, Najran, Saudi Arabia.
Nasher H Alyami Laboratory Medicine Department, Hematology Unit, Ministry of Health, Najran General Hospital, Najran, Saudi Arabia.
Abdelaziz Aman Internal Medicine, Endocrine and Diabetes, King Khalid Hospital, Najran, Saudi Arabia.
Islam A Seada Cardiothoracic Surgery, King Khalid Hospital, Najran, Saudi Arabia.
Abdullah Abu Bakar Ophthalmology, King Khalid Hospital, Najran, Saudi Arabia.
Samer Alkarak General Surgery, King Khalid Hospital, Najran, Saudi Arabia.
Mohammed S Bazuqamah Laboratory Medicine, King Khalid Hospital, Najran, Saudi Arabia.
Mahran Mohammed Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Ammar Idris Oncology, King Khalid Hospital, Najran, Saudi Arabia.
Faisal Ahmed Urology, Ibb University, Ibb, Yemen.
Mohamed Badheeb Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, USA.

DOI:

https://doi.org/10.31557/apjcc.2026.11.2.169-177

Keywords:

Hodgkin lymphoma, progression-free survival, ABVD chemotherapy, clinical outcomes, retrospective study, prognosis

Abstract

Introduction: Hodgkin lymphoma (HL) is characterized by heterogeneous clinical outcomes influenced by a complex interplay of biological and clinical factors. This study aims to delineate presentation patterns, treatment responses, and prognostic indicators within a Saudi Arabian cohort, with consideration of regional epidemiological variations.

Materials and Methods: A retrospective cohort study was conducted involving 23 patients diagnosed with HL at King Khalid Hospital, Najran, between 2014 and 2021. Diagnoses were established according to the World Health Organization (WHO) 2017 classification. Treatment responses were assessed after every two chemotherapy cycles using RECIST version 1.1, due to limited availability of PET imaging modalities. Progression-free survival (PFS) predictors were analyzed using univariate Cox proportional hazards regression, with explicit acknowledgment of the limited statistical precision stemming from the small sample size.

Results: The mean age was 36.3 ± 16.3 years, with males constituting 60.9% of the cohort. Nodular sclerosis was the most common histological subtype (65.2%), and stage III was the most frequent at diagnosis (43.5%). The ABVD chemotherapy regimen yielded an objective response rate of 78.3%, with a complete response observed in 43.5% of patients. At a median follow-up of 33 months, univariate analysis identified significant associations between reduced PFS and advanced disease stage (III/IV vs. I/II; hazard ratio [HR] 3.26, 95% confidence interval [CI] 0.34–31.35; p=0.001), high International Prognostic Score (IPS ≥3 vs. 0–2; HR 17.93, 95% CI 1.85–173.94; p=0.013), and increasing age (per year; HR 1.21, 95% CI 1.10–1.34; p<0.001).

Conclusions: In this cohort, advanced disease stage, elevated IPS, and increasing age were associated with inferior PFS, consistent with established prognostic models despite regional epidemiological differences. These findings underscore the necessity for larger, prospective studies to validate risk stratification tools and optimize management strategies in similar healthcare settings.