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Single-center experience of childhood Hodgkin lymphoma treated without radiotherapy

Year 2021, Volume: 4 Issue: 6, 853 - 857, 24.09.2021
https://doi.org/10.32322/jhsm.984394

Abstract

Aim: Hodgkin lymphoma (HL) constitutes 40% of childhood lymphomas and approximately 6% of all childhood cancers. It is tried to achieve cure with combined treatment modalities consisting of chemotherapy, radiotherapy, monoclonal antibodies, and new treatment agents such as nivolumab. Radiotherapy-related infertility, secondary cancer, thyroid dysfunction, cardiovascular diseases, pulmonary fibrosis, and local skin reactions can be seen in the pediatric age group with a long life expectancy. In this article, pediatric patients diagnosed with Hodgkin lymphoma without the use of radiotherapy in the treatment were evaluated retrospectively and the survival results were reported as a single-center experience.
Material and Method: The patients with Hodgkin Lymphoma in the Pediatrics Hematology-Oncology Center at Erciyes University between January 2010 and December 2019 were included in the study and the data of the patients were evaluated retrospectively.
Results: In 68 pediatric patients with a mean age of 10.7 (±4.6) years, the male/female ratio was 1.3. The most detected finding at the time of diagnosis was cervical lymphadenopathy (83.8%). The most common mixed cellular subtype was identified (48.5%). Stage I-II disease was observed in 38.3% of the patients, and stage III-IV disease was observed in 61.7% of the patients. The median follow-up period of the patients was 61 (range, 8.3-161.6) months. Disease-free survival and overall survival were 85.3% and 94.1%, respectively. Treatment modalities to be used in this disease group, which has a high chance of cure after cytotoxic treatment, should be selected considering treatment-related long-term complications.
Conclusion: Acceptable good results obtained without radiotherapy are satisfactory and the chance of curative success will increase with the addition of new target agents to the treatment.

Supporting Institution

Yok

Project Number

Yok

Thanks

The authors thank Prof. Dr. Mehmet Akif ÖZDEMİR, Prof. Dr. Türkan PATIROĞLU for their valuable contributions to the study.

References

  • Zupanec S. Lymphoma. In: Tomlinson D, Kline NE, eds. Pediatric Oncology Nursing. Advanced Clinical Handbook. New York: Springer; 2010: 33–57.
  • Friedman D. Hodgkin Lymphoma. In: Lanzkowsky P, Lipton JM, Fish JD. Lanzkowsky's manual of pediatric hematology and oncology: Academic Press; 2016: 429-41.
  • Ashraf MS, Naz F, Yakoob MY. Characteristics and survival outcomes of children with Hodgkin lymphoma treated primarily with chemotherapy. J Pediatr Hematol Oncol 2019; 41: 452-6. 
  • Cuccaro A, Bartolomei F, Cupelli E, Galli E, Giachelia M, Hohaus S. Prognostic factors in hodgkin lymphoma. Mediterr J Hematol Infect Dis 2014; 6: e2014053.
  • Dores GM, Metayer C, Curtis RE, et al. Second malignant neoplasms among long-term survivors of Hodgkin's disease: a population-based evaluation over 25 years. J Clin Oncol 2002; 20: 3484-94.
  • Hancock SL, Donaldson SS, Hoppe RT. Cardiac disease following treatment of Hodgkin's disease in children and adolescents. J Clin Oncol 1993; 11: 1208-15.
  • Hancock SL, Cox RS, McDougall IR. Thyroid diseases after treatment of Hodgkin's disease. N Engl J Med 1991; 325: 599-605. 
  • Patiroglu T, Haluk Akar H, Gilmour K, et al. A case of XMEN syndrome presented with severe auto-immune disorders mimicking autoimmune lymphoproliferative disease. Clin Immunol 2015; 159: 58-62.
  • Somekh I, Marquardt B, Liu Y, et al. Novel mutations in RASGRP1 are associated with immunodeficiency, immune dysregulation, and EBV-induced lymphoma. J Clin Immunol 2018; 38: 699-710.
  • Cansever M, Zietara N, Chiang SCC, et al. A rare case of activated phosphoinositide 3-kinase delta syndrome (APDS) presenting with hemophagocytosis complicated with hodgkin lymphoma. J Pediatr Hematol Oncol 2020; 42: 156-9.
  • Trehan A, Singla S, Marwaha RK, Bansal D, Srinivasan R. Hodgkin lymphoma in children: experience in a tertiary care centre in India. J Pediatr Hematol Oncol 2013; 35: 174-9.
  • Sherief LM, Elsafy UR, Abdelkhalek ER, et al. Hodgkin lymphoma in childhood: clinicopathological features and therapy outcome at 2 centers from a developing country. Medicine 2015; 94: 15.
  • Stoneham S, Ashley S, Pinkerton R, Hewitt M, Wallace W, Shankar AJEJoC. Hodgkin’s lymphoma in children aged 5 years or less–The United Kingdom experience. Eur J Cancer 2007; 43: 1415-21.
  • Hsu SC, Metzger ML, Hudson MM, et al. Comparison of treatment outcomes of childhood Hodgkin lymphoma in two US centers and a center in Recife, Brazil. Pediatr Blood Cancer 2007; 49: 139-44.
  • Faizan M, Taj MM, Anwar S, et al. Comparison of presentation and outcome in 100 pediatric Hodgkin lymphoma patients treated at Children Hospital, Lahore, Pakistan and Royal Marsden Hospital, UK. J Coll Physician Surg Pak 2016; 26: 904-7.
  • Karhan AN, Varan A, Akyüz C, et al. Outcome of 102 patients under 5 years of age with Hodgkin lymphoma. Arch Argent Pediatr 2019; 117: 459-65.
  • Cavdar AO, Gozdasoglu S, Yavuz G, et al. Characteristics of “Early Type-I Pattern” (0-6 years) Hodgkin’s Disease in Turkish Children. Turk J Haematol 2002; 19: 55-62.
  • Bazzeh F, Rihani R, Howard S, Sultan I. Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988-2005: an analysis of 21 734 cases. Leukemia & lymphoma 2010; 51: 2198-207.
  • Naresh KN, Johnson J, Srinivas V, et al. Epstein-Barr virus association in classical Hodgkin’s disease provides survival advantage to patients and correlates with higher expression of proliferation markers in Reed-Sternberg cells. Ann Oncol 2000; 11: 91-6.
  • Shapira-Zaltsberg G, Wilson N, et al. Whole-body diffusion-weighted MRI compared to 18 FFDG PET/CT in initial staging and therapy response assessment of Hodgkin lymphoma in pediatric patients. Can Assoc Radiol J 2020; 71: 217-25.
  • Gómez-Almaguer D, González-Llano O, Jiménez-Antolinez V, Gómez-De León A. Treatment of classical Hodgkin's lymphoma in children and adolescents. Expert Opin Pharmacother 2019; 20: 1227-34.
  • Giulino-Roth L, O'Donohue T, Chen Z, et al. Outcome of children and adolescents with relapsed Hodgkin lymphoma treated with high-dose therapy and autologous stem cell transplantation: the memorial sloan kettering cancer center experience. Leuk Lymphoma 2018; 59: 1861–70.
  • Nachman JB, Sposto R, Herzog P, et al. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 2002; 20: 3765-71.
  • Ali A, Sayed H, Farrag A, El-Sayed MJLr. Risk-based combined-modality therapy of pediatric Hodgkin's lymphoma: A retrospective study. Leukemia Res 2010; 34: 1447-52.
  • Donaldson SS, Link MP, Weinstein HJ, et al. Final results of a prospective clinical trial with VAMP and low-dose involved-field radiation for children with low-risk Hodgkin's disease. J Clin Oncol 2007; 25: 332-7.
  • Schwartz CL, Constine LS, Villaluna D, et al. A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of P9425. Blood 2009; 114: 2051-9.
Year 2021, Volume: 4 Issue: 6, 853 - 857, 24.09.2021
https://doi.org/10.32322/jhsm.984394

Abstract

Project Number

Yok

References

  • Zupanec S. Lymphoma. In: Tomlinson D, Kline NE, eds. Pediatric Oncology Nursing. Advanced Clinical Handbook. New York: Springer; 2010: 33–57.
  • Friedman D. Hodgkin Lymphoma. In: Lanzkowsky P, Lipton JM, Fish JD. Lanzkowsky's manual of pediatric hematology and oncology: Academic Press; 2016: 429-41.
  • Ashraf MS, Naz F, Yakoob MY. Characteristics and survival outcomes of children with Hodgkin lymphoma treated primarily with chemotherapy. J Pediatr Hematol Oncol 2019; 41: 452-6. 
  • Cuccaro A, Bartolomei F, Cupelli E, Galli E, Giachelia M, Hohaus S. Prognostic factors in hodgkin lymphoma. Mediterr J Hematol Infect Dis 2014; 6: e2014053.
  • Dores GM, Metayer C, Curtis RE, et al. Second malignant neoplasms among long-term survivors of Hodgkin's disease: a population-based evaluation over 25 years. J Clin Oncol 2002; 20: 3484-94.
  • Hancock SL, Donaldson SS, Hoppe RT. Cardiac disease following treatment of Hodgkin's disease in children and adolescents. J Clin Oncol 1993; 11: 1208-15.
  • Hancock SL, Cox RS, McDougall IR. Thyroid diseases after treatment of Hodgkin's disease. N Engl J Med 1991; 325: 599-605. 
  • Patiroglu T, Haluk Akar H, Gilmour K, et al. A case of XMEN syndrome presented with severe auto-immune disorders mimicking autoimmune lymphoproliferative disease. Clin Immunol 2015; 159: 58-62.
  • Somekh I, Marquardt B, Liu Y, et al. Novel mutations in RASGRP1 are associated with immunodeficiency, immune dysregulation, and EBV-induced lymphoma. J Clin Immunol 2018; 38: 699-710.
  • Cansever M, Zietara N, Chiang SCC, et al. A rare case of activated phosphoinositide 3-kinase delta syndrome (APDS) presenting with hemophagocytosis complicated with hodgkin lymphoma. J Pediatr Hematol Oncol 2020; 42: 156-9.
  • Trehan A, Singla S, Marwaha RK, Bansal D, Srinivasan R. Hodgkin lymphoma in children: experience in a tertiary care centre in India. J Pediatr Hematol Oncol 2013; 35: 174-9.
  • Sherief LM, Elsafy UR, Abdelkhalek ER, et al. Hodgkin lymphoma in childhood: clinicopathological features and therapy outcome at 2 centers from a developing country. Medicine 2015; 94: 15.
  • Stoneham S, Ashley S, Pinkerton R, Hewitt M, Wallace W, Shankar AJEJoC. Hodgkin’s lymphoma in children aged 5 years or less–The United Kingdom experience. Eur J Cancer 2007; 43: 1415-21.
  • Hsu SC, Metzger ML, Hudson MM, et al. Comparison of treatment outcomes of childhood Hodgkin lymphoma in two US centers and a center in Recife, Brazil. Pediatr Blood Cancer 2007; 49: 139-44.
  • Faizan M, Taj MM, Anwar S, et al. Comparison of presentation and outcome in 100 pediatric Hodgkin lymphoma patients treated at Children Hospital, Lahore, Pakistan and Royal Marsden Hospital, UK. J Coll Physician Surg Pak 2016; 26: 904-7.
  • Karhan AN, Varan A, Akyüz C, et al. Outcome of 102 patients under 5 years of age with Hodgkin lymphoma. Arch Argent Pediatr 2019; 117: 459-65.
  • Cavdar AO, Gozdasoglu S, Yavuz G, et al. Characteristics of “Early Type-I Pattern” (0-6 years) Hodgkin’s Disease in Turkish Children. Turk J Haematol 2002; 19: 55-62.
  • Bazzeh F, Rihani R, Howard S, Sultan I. Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988-2005: an analysis of 21 734 cases. Leukemia & lymphoma 2010; 51: 2198-207.
  • Naresh KN, Johnson J, Srinivas V, et al. Epstein-Barr virus association in classical Hodgkin’s disease provides survival advantage to patients and correlates with higher expression of proliferation markers in Reed-Sternberg cells. Ann Oncol 2000; 11: 91-6.
  • Shapira-Zaltsberg G, Wilson N, et al. Whole-body diffusion-weighted MRI compared to 18 FFDG PET/CT in initial staging and therapy response assessment of Hodgkin lymphoma in pediatric patients. Can Assoc Radiol J 2020; 71: 217-25.
  • Gómez-Almaguer D, González-Llano O, Jiménez-Antolinez V, Gómez-De León A. Treatment of classical Hodgkin's lymphoma in children and adolescents. Expert Opin Pharmacother 2019; 20: 1227-34.
  • Giulino-Roth L, O'Donohue T, Chen Z, et al. Outcome of children and adolescents with relapsed Hodgkin lymphoma treated with high-dose therapy and autologous stem cell transplantation: the memorial sloan kettering cancer center experience. Leuk Lymphoma 2018; 59: 1861–70.
  • Nachman JB, Sposto R, Herzog P, et al. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 2002; 20: 3765-71.
  • Ali A, Sayed H, Farrag A, El-Sayed MJLr. Risk-based combined-modality therapy of pediatric Hodgkin's lymphoma: A retrospective study. Leukemia Res 2010; 34: 1447-52.
  • Donaldson SS, Link MP, Weinstein HJ, et al. Final results of a prospective clinical trial with VAMP and low-dose involved-field radiation for children with low-risk Hodgkin's disease. J Clin Oncol 2007; 25: 332-7.
  • Schwartz CL, Constine LS, Villaluna D, et al. A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of P9425. Blood 2009; 114: 2051-9.
There are 26 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Ebru Yılmaz 0000-0003-4802-0986

Memnune Arslan 0000-0003-4227-300X

Şefika Akyol This is me 0000-0003-0051-4274

Alper Özcan 0000-0002-6100-1205

Gökmen Zararsız This is me 0000-0001-5801-1835

Ümmühan Abdulrezzak 0000-0002-7100-1866

Olgun Kontaş 0000-0002-1372-1128

Özlem Canöz 0000-0002-0200-6970

Ekrem Ünal 0000-0002-2691-4826

Musa Karakükçü 0000-0003-2015-3541

Project Number Yok
Publication Date September 24, 2021
Published in Issue Year 2021 Volume: 4 Issue: 6

Cite

AMA Yılmaz E, Arslan M, Akyol Ş, Özcan A, Zararsız G, Abdulrezzak Ü, Kontaş O, Canöz Ö, Ünal E, Karakükçü M. Single-center experience of childhood Hodgkin lymphoma treated without radiotherapy. J Health Sci Med / JHSM. September 2021;4(6):853-857. doi:10.32322/jhsm.984394

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