To analyse Paediatric Hodgkin Lymphoma (HL) patients treated at our centre over a 20 year period in terms of survival, late side effects and secondary malignancies.
This is a retrospective analysis of 110 Paediatric HL patients, who had their initial complete workup and completed the treatment at our institute from January 1991 to December 2010. Patients were staged according to the modified Ann Arbor system. Patients with early stage HL (Stages IA, IB and IIA) were planned for 4 cycles of chemotherapy. All the other patients were planned for 6-8 cycles of chemotherapy with radiotherapy (RT) for initial bulky disease. They were under close follow up for 5 years and annually thereafter for late side effects.
The median age of presentation was 10 years (range 1-18). There were of a total of 86 males and 24 females (ratio 3.5:1). 57.27% patients presented with B symptoms. 13 patients had bulky disease at initial presentation. The histopathological examination revealed mixed cellularity (MC) in 77.27% of patients, followed by nodular sclerosis (NS) in 8.18%. The median follow-up was 147.5 months. The 5 years progression free survival (PFS) was 85.45%. The median overall survival (OS) for the entire cohort has not been reached. The OS at 5 years is 93.63%. 4.54% patients developed bleomycin induced chronic interstitial lung disease and died of respiratory complications. 1 out of 14 patients who took MOPP regimen developed sterility due to mechlorethamine. None of the patients developed cardiotoxicity till date. None of the patients developed second malignancies till date.
Paediatric HL is a highly curable disease. Paediatric HL occurs at a younger age in our study, with a median age of 10 years with male predominance and MC was the most common subtype. There is no significant statistical difference in the OS of early and advanced stage paediatric HL patients in our study. Most relapses occurred within first 3 years. Patients who developed refractory disease during or within 1 year of completing therapy responded poorly to conventional salvage therapy. With the current effective non-cross resistant multidrug regimen chemotherapy, there is less incidence for longterm side effects with prolonged survival.
Clinical trial identification
All authors have declared no conflicts of interest.