Clinical characteristics and outcome of pediatric patients with stage IV Hodgkin lymphoma

Belgaumi, Asim; Al-Kofide, Amani; Khafaga, Yasser; Joseph, Nicey; Jamil-Malik, Rubina; Siddiqui, Khawar; Sabbah, Rajeh

doi:10.1016/s1658-3876(09)50038-6

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…We also observed that bulky disease significantly affects outcome; this result was also shown in other published studies [28] [30]; this may be related by the relatively prolonged period interval between the onset of symptoms, diagnosis, and treatment outset.…”

Section: Discussionsupporting

confidence: 89%

Impact of using combined chemotherapy regimen in children with Hodgkin lymphoma in countries with limited resources: a single center experience in Iraq

2023

JPTCP

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Objective/Background: Data about Hodgkin lymphoma (HL) in developing countries are scattered. The aim of this study is to present clinical features and outcome of children with HL using combined different chemotherapy regimens. Response-based approach was applied irrespective of risk stratification. Methods: Patients aged 18 years and younger who were diagnosed with HL between January 2014 and December 2021 in a cancer center in Iraq, were recruited. Patients were stratified into three risk groups. Initial treatment with induction chemotherapy (i.e., 2 cycles of ABVD) was applied to all patients. Patients who achieved complete radiological response to induction chemotherapy continued with 4-6 cycles of ABVD; radiotherapy was omitted. Patients with slow early response received 3 cycles of COPDac after 3rd cycle of ABVD, followed by radiotherapy. Results: fifty-nine patients were enrolled in this study. The median age was 7 years. Twenty (33.9%) patients were stage III, followed by stage II (32.2%). Twenty-five patients had B symptoms. Initial splenic involvement was found in 11 patients. Approximately one third of patients had bulky disease (n = 19; 32.2%). The most common histology was mixed cellularity (n = 44). The median follow-up was 2.7 year (range from 0.1 to 7.5 years). The 5-year estimates of survival and EFS were 92% and 78% ±10%, respectively. Only bulky disease had a significant negative influence on the outcome. Conclusion: Good outcomes for pediatric HL patients can be achieved in low and middle income countries. Response-based therapy approach is feasible to reduce long term treatment-related sequel.

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Section: Discussionsupporting

confidence: 89%

Impact of using combined chemotherapy regimen in children with Hodgkin lymphoma in countries with limited resources: a single center experience in Iraq

2023

JPTCP

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“…However, low-risk patients with late relapse and limited stage may be retrieved with standard dose chemotherapy (SDCT) and RT. The most common prognostic factors are chemosensitivity to initial salvage therapy [110], primary progressive disease [111, 112], time to relapse [113], and extranodal disease [114]. As with adult patients, pediatric patients also show poor prognosis, associated with time from diagnosis to first relapse of <1 year [115].…”

Section: Treatmentmentioning

confidence: 99%

Pediatric Hodgkin lymphoma- biomarkers, drugs, and clinical trials for translational science and medicine

et al. 2016

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Hodgkin lymphoma (HL) is a lymphoid malignancy that is typically derived from germinal-center B cells. EBV infection, mutations in NF-κB pathway genes, and genetic susceptibility are known risk factors for developing HL. CD30 and NF-κB have been identified as potential biomarkers in pediatric HL patients, and these molecules may represent therapeutic targets. Although current risk adapted and response based treatment approaches yield overall survival rates of >95%, treatment of relapse or refractory patients remains challenging. Targeted HL therapy with the antibody-drug conjugate Brentuximab vedotin (Bv) has proven to be superior to conventional salvage chemotherapy and clinical trials are being conducted to incorporate Bv into frontline therapy that substitutes Bv for alkylating agents to minimize secondary malignancies. The appearance of secondary malignancies has been a concern in pediatric HL, as these patients are at highest risk among all childhood cancer survivors. The risk of developing secondary leukemia following childhood HL treatment is 10.4 to 174.8 times greater than the risk in the general pediatric population and the prognosis is significantly poorer than the other hematological malignancies with a mortality rate of nearly 100%. Therefore, identifying clinically valuable biomarkers is of utmost importance to stratify and select patients who may or may not need intensive regimens to maintain optimal balance between maximal survival rates and averting late effects. Here we discuss epidemiology, risk factors, staging, molecular and genetic prognostic biomarkers, treatment for low and high-risk patients, and the late occurrence of secondary malignancies in pediatric HL.

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“…A study by Belgaumi et al reported less than 80% of patients had HL, 94% were diagnosed with early stage, and 96% were late stage patients [ 29 ]. For patients of early- and advanced-stage HL, a variety of prognostic variables were identified: bulky disease, ESR, LDH, hemoglobin, and the presence of B-symptoms, with age being the most important one [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Hodgkin Lymphoma With Reference to Prognostic Markers

Ahmed¹,

Tariq²,

Ashfaq³

et al. 2022

Cureus

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Objectives: This study aimed to determine the impact of prognostic markers on the outcomes of Hodgkin lymphoma. Methods: It is a cross-sectional, single-center study. A total of 60 patients diagnosed with Hodgkin lymphoma were recruited for the study over five years between 2016 to 2020. The study setting was the National Institute of Blood and Bone Marrow Transplant in Pakistan. The Statistical Package for Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY, USA) was used for statistical analysis. Results: In the study population, 63.3% of the patients were male (38/60), and 36.7% were female (22/60). Hodgkin lymphoma was divided into four stages: stage I (18.3%), stage II (18.3%), stage III (46.7%), and stage IV (16.7%). Patients in stage III had a higher value of hemoglobin (Hb) than in other stages of the disease. The erythrocyte sedimentation rate was high in 56.7% of stage III patients than in patients of the other stages. The lactate dehydrogenase (LDH) levels were not under the normal range in 51.6% of patients. Only 20% of patients in stage III had LDH values within the normal range, whereas 26.6% did not. Conclusion: There was a significant impact of prognostic factors on the survival of patients with Hodgkin lymphoma.

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Clinical characteristics and outcome of pediatric patients with stage IV Hodgkin lymphoma

Abstract: Stage IV disease is associated with poor risk features and confers a worse outcome than stage I-III disease. Achievement of complete remission with CT is an important prognostic feature. Slow responders may require novel and/or aggressive therapy to achieve complete remission.

Cited by 6 publications

References 22 publications

Impact of using combined chemotherapy regimen in children with Hodgkin lymphoma in countries with limited resources: a single center experience in Iraq

Impact of using combined chemotherapy regimen in children with Hodgkin lymphoma in countries with limited resources: a single center experience in Iraq

Pediatric Hodgkin lymphoma- biomarkers, drugs, and clinical trials for translational science and medicine

The Outcome of Hodgkin Lymphoma With Reference to Prognostic Markers

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