Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience
Abstract Background Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treate...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-09-01
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| Series: | Journal of the Egyptian National Cancer Institute |
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| Online Access: | https://doi.org/10.1186/s43046-023-00189-w |
| _version_ | 1827709010922438656 |
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| author | Nesreen Ali Mohamed Mansour Ehab Khalil Emad Ebeid |
| author_facet | Nesreen Ali Mohamed Mansour Ehab Khalil Emad Ebeid |
| author_sort | Nesreen Ali |
| collection | DOAJ |
| description | Abstract Background Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treated at the National Cancer Institute (NCI), Cairo University. Methods All newly diagnosed cases of classic HL treated between January 2016 and December 2018 were included in this study. Results The median age at initial presentation was 8 years in 69 eligible individuals, with a male-to-female ratio of 4.7:1. Eighteen percent of patients had an elevated erythrocyte sedimentation rate (ESR) of more than 50, 42% had more than three lymph node (LN) group involvements, 18.8% had bulky disease, 52.2% were at an advanced stage, and 34% had B symptoms. Age > 15 years, B symptoms, > 3 LN group involvement, extra-nodal disease, and advanced stages significantly affected the overall survival rate (OS) (P-values = 0.03, 0.033, 0.008, 0.017, and 0.032). There was no statistically significant difference between patients who got combined modality therapy (CMT) and those who received chemotherapy alone (3-year OS and event-free survival (EFS) were 95.5% and 87.6% vs. 89.9% and 83.3%, P-values of 0.70 and 0.90). Patients with an interim-negative positron emission tomography-computed tomography (PET-CT) had a 3-year OS of 94.7%, compared to 74.1% in patients with an interim-positive PET-CT (P = 0.06), suggesting that rapid early response (RER) is a significant prognostic factor. There was no statistically significant survival difference between patients with a negative interim PET-CT who got CMT and those who received chemotherapy alone (3-year OS and EFS: 100% and 88.2% vs. 95% and 90%; P = 0.35 and 0.70, respectively). Three-year OS was 93.3% and 100%, and EFS was 74.3% and 100% (P = 0.495 and 0.196%) for those who got 15 Gy versus those who received 20 Gy or more, respectively. At the end of the study, the OS and EFS at 3 years for the whole group were 91.9% and 83.6%. Conclusion Treatment with risk- and response-adaptive treatment should be the standard of care for treating pediatric patients with HL. |
| first_indexed | 2024-03-10T17:13:55Z |
| format | Article |
| id | doaj.art-3019ffe16c60471b896c515cd0218046 |
| institution | Directory Open Access Journal |
| issn | 2589-0409 |
| language | English |
| last_indexed | 2024-03-10T17:13:55Z |
| publishDate | 2023-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of the Egyptian National Cancer Institute |
| spelling | doaj.art-3019ffe16c60471b896c515cd02180462023-11-20T10:33:12ZengSpringerOpenJournal of the Egyptian National Cancer Institute2589-04092023-09-0135111010.1186/s43046-023-00189-wOutcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experienceNesreen Ali0Mohamed Mansour1Ehab Khalil2Emad Ebeid3Department of Pediatric Oncology and Hematology, National Cancer Institute, Cairo UniversityDepartment of Pediatric Oncology and Hematology, Children Cancer Hospital Egypt (CCHE —57357)Department of Radiation Oncology, National Cancer Institute, Cairo UniversityDepartment of Pediatric Oncology and Hematology, National Cancer Institute, Cairo UniversityAbstract Background Hodgkin lymphoma (HL) is a highly curable malignant tumor. Risk-adapted treatment for children with HL aims to maximize survival while minimizing toxicity. The purpose of this study is to evaluate the outcome and prognostic characteristics of Egyptian pediatric HL patients treated at the National Cancer Institute (NCI), Cairo University. Methods All newly diagnosed cases of classic HL treated between January 2016 and December 2018 were included in this study. Results The median age at initial presentation was 8 years in 69 eligible individuals, with a male-to-female ratio of 4.7:1. Eighteen percent of patients had an elevated erythrocyte sedimentation rate (ESR) of more than 50, 42% had more than three lymph node (LN) group involvements, 18.8% had bulky disease, 52.2% were at an advanced stage, and 34% had B symptoms. Age > 15 years, B symptoms, > 3 LN group involvement, extra-nodal disease, and advanced stages significantly affected the overall survival rate (OS) (P-values = 0.03, 0.033, 0.008, 0.017, and 0.032). There was no statistically significant difference between patients who got combined modality therapy (CMT) and those who received chemotherapy alone (3-year OS and event-free survival (EFS) were 95.5% and 87.6% vs. 89.9% and 83.3%, P-values of 0.70 and 0.90). Patients with an interim-negative positron emission tomography-computed tomography (PET-CT) had a 3-year OS of 94.7%, compared to 74.1% in patients with an interim-positive PET-CT (P = 0.06), suggesting that rapid early response (RER) is a significant prognostic factor. There was no statistically significant survival difference between patients with a negative interim PET-CT who got CMT and those who received chemotherapy alone (3-year OS and EFS: 100% and 88.2% vs. 95% and 90%; P = 0.35 and 0.70, respectively). Three-year OS was 93.3% and 100%, and EFS was 74.3% and 100% (P = 0.495 and 0.196%) for those who got 15 Gy versus those who received 20 Gy or more, respectively. At the end of the study, the OS and EFS at 3 years for the whole group were 91.9% and 83.6%. Conclusion Treatment with risk- and response-adaptive treatment should be the standard of care for treating pediatric patients with HL.https://doi.org/10.1186/s43046-023-00189-wHodgkin lymphomaPediatricOutcomePrognostic factors |
| spellingShingle | Nesreen Ali Mohamed Mansour Ehab Khalil Emad Ebeid Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience Journal of the Egyptian National Cancer Institute Hodgkin lymphoma Pediatric Outcome Prognostic factors |
| title | Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience |
| title_full | Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience |
| title_fullStr | Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience |
| title_full_unstemmed | Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience |
| title_short | Outcome and prognostic factors of pediatric patients with Hodgkin lymphoma: a single-center experience |
| title_sort | outcome and prognostic factors of pediatric patients with hodgkin lymphoma a single center experience |
| topic | Hodgkin lymphoma Pediatric Outcome Prognostic factors |
| url | https://doi.org/10.1186/s43046-023-00189-w |
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