Lymphocyte predominant Hodgkin Disease: Clinico-pathologic features and results of treatment—The pediatric oncology group experience

Abstract

Purpose In this report, the Pediatric Oncology Group (POG) experience with lymphocyte predominant Hodgkin Disease (LPHD) in children is reviewed. Materials and Methods From 1984–1993, the POG conducted 3 clinical trials for advanced stage HD and 2 for early stage HD. There were 26 cases of LPHD in 613 patients in these trials. Patients' ages ranged from 3.1–17.8 years (mean of 12.9 years). There was a marked male predominance. Results Histologic subtypes were 17 nodular, 8 diffuse pattern; 1 was indeterminant. The sites involved at diagnosis were primarily the peripheral lymph nodes. Fourteen patients had stage (S) I disease; 9 had SII; 3 had SIII; there was no SIV disease. Only 4 of 26 patients had B symptoms. All 26 patients achieved complete remission, 10 with radiotherapy, 6 with chemotherapy and 10 with combined modality therapy. Treatment was not uniform since patients were registered on different protocols. Event‐free survival after 5 years was 86.5 percent. Two patients developed and succumbed to large cell, T‐cell type, non‐Hodgkin lymphoma (NHL). Conclusions Optimal treatment for LPHD should focus on efforts to limit the risk of second malignancy. Med. Pediatr. Oncol. 29:519–525, 1997. © 1997 Wiley‐Liss, Inc.

Mycobacterium avium intracellulare Infection Coexistent With Nodular Lymphocyte Predominant Hodgkin Lymphoma Involving the Lung

“…1,5 NLPHL stage IA and IIA are treated with surgical resection followed by chemotherapy; radiation has been used in some cases. 5,6 Advanced stage NLPHL is rare and lung involvement has been reported in only 3 patients among several pediatric studies 1,6-8 ( Table 2). Lung involvement is reported in 1% to 3% of adults with NLPHL.…”

“…The chemotherapy regimens include cyclophosphamide, vincristine, procarbazine, prednisone/ doxorubicin, bleomycin, vinblastine, bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone, and doxorubicin, bleomycin, vincristine, etoposide. [6][7][8] These patients derive no clinical benefit from radiation therapy. 12 For adults with advanced stage disease, EFS is 88% and overall survival is 77%.…”

Prognostic factors in pediatric Hodgkin disease

“…LD is extremely rare in children; it has a dismal prognosis in adults. LP accounts for approximately 10% of pediatric HD and is usually associated with low-stage disease with excellent rates of disease-free survival [15]. Relapses are rare and occur late, with risk of non-Hodgkin lymphoma as a secondary malignancy nearly as high as that of HD relapse.…”

Current Approaches to the Management of Pediatric Hodgkin Lymphoma

“…Currently, the standard treatment for children with NLPHL is chemotherapy and low-dose IFRT. [22,23] However, there is emerging evidence that observation alone may be sufficient management for patients with completely resected disease. The French Society of Pediatric Oncology treated 13 NLPHL patients with surgery alone.…”