Developing anticancer chemotherapy services in a developing country: Hodgkin lymphoma experience

Abstract

Pediatric HL in India was characterized by advanced disease at presentation. Mixed-cellularity was the predominant histological subtype. An effective program was developed with initial attention to patients with HL.

Hodgkin Lymphoma in Children

“…The association of B symptoms with advanced stage was significant with two thirds of patients with B symptoms having advanced-stage disease. [7][8][9]14 This also corresponds to figures from other resource-poor nations. 7,8,[12][13] This is in contrast to the situation in affluent nations, where only 25% to 30% cases have B symptoms.…”

“…[7][8][9][10][11][12][13][14] Reports from Europe and North America have given the mean/median age of presentation of the childhood form of HL as ranging between 12 and 15 years. Boys presented at a statistically significant younger age (7.72 ± 2.4 vs. 9.66 ± 3.1 in girls).…”

“…[7][8][9][10][11][12][13][14] Reports from Europe and North America have given the mean/median age of presentation of the childhood form of HL as ranging between 12 and 15 years. 7,8,14 Male predominance with reported male to female ratios of 1.7:1, 1.2:1, and 3.1:1 is a worldwide phenomenon in HL. In contrast, the literature from the developed world reveals only around 5% of cases to be below 5 years of age.…”

“…3,6,7 The male to female ratio in our study was 10.5:1. [7][8][9]14 Studies from other developing nations have shown 77.1% and 58.3% of patients with advanced-stage disease. Studies reported from the subcontinent have observed high male to female ratios of 7.4:1, 6:1, and 10.5:1.…”

“…This supplements data from our country where previous studies have shown mixed cellularity subtype to be the most frequent subtype, reports giving figures of 50% to 80%. 7, 14 We have used different chemotherapeutic regimens and have OS and EFS rates of 92.7% and 77.75%, respectively, at 5 years. [11][12][13]19 In the pediatric age group, most reports from North America and Europe have shown nodular sclerosis (60% to 70%) as the most frequent subtype.…”