With the development of more potent treatment options, the survival rate for Hodgkin lymphoma has increased over time.
Treatment options for children with Hodgkin lymphoma (HL) have changed dramatically over the years, mainly as a result of developments in radiation therapy (RT) and chemotherapy (ChT). In the past, both children and adults received the same methods and doses of RT. The success of ChT in relapsed patients motivated the initial mixed-modality trials.
A study published in the Journal of Community Medicine and Public Health Reports documented the treatment protocols and 20-year survival rates for children with Hodgkin lymphoma.
Participant Characteristics
In this retrospective, single-center study conducted at Istanbul University Oncology Institute, 96 children with HL treated with chemotherapy, radiation therapy, or both were the subjects. The average participant was 10 years old (range 3–18 years), with a male predominance (2.7:1).
Occurrence of Hodgkin Lymphoma
According to the World Health Organization’s pathological classification, 47 patients (49%) had nodular sclerosis, 39 (41%) had mixed cellularity, 7 (7%) had lymphocyte predominance, and 3 (3%) had lymphocyte depletion. According to Ann Arbor classification, stage I–II patients comprised 57 (59%) of the total patients, with 21 (22%) displaying B symptoms. There were 25 patients with stage III disease (26%) and 14 with stage IV disease (15%).
Treatment and Mortality According to the Staging of Hodgkin Lymphoma
Two of the 96 patients with HL in stage IA did not get ChT and were only treated with RT. Moreover, 44 out of 94 patients in complete response (CR) after receiving combination therapy or ChT or RT alone for stages I–II and IIIA had no evidence of illness at the time of analysis. CR was achieved in 20 of 31 patients at stages IB and IV. One stage IV patient and two stage II patients experienced progressive disease (PD) following ChT, while both stage II patients who received RT achieved CR. After RT, 29 patients with PR achieved CR, and five achieved PR. Two of these PR patients ultimately succumbed to their disease. Death from PD occurred in one patient at stage IV following ChT.
Disease-Free Survival and Overall Survival After Treatment
Age over 11, stage IIIB, and stage IV significantly affect disease-free survival (DFS). On multivariate analysis, stage was the only factor for DFS. Overall DFS and overall survival (OS) rates over 5 and 10 years for the entire cohort were 95%, 95%, 96%, and 95%, respectively. Seven people died in total; however, only four died as a result of disease progression. One patient had treatment-related mortality, and the deaths of two patients were not caused by their diseases.
According to the results of this study, children with HL demonstrated high response rates and improved survival.
Source:
Yücel, S., Güral, Z., Bozkurt, M., İribaş, A., & Kebudi, R. (2023). Hodgkin Lymphoma in Childhood and Adolescence: A Single-Institution Experience. J Comm Med and Pub Health Rep, 4(06).https://doi.org/10.38207/JCMPHR/2023/SEP04060395
