Pediatric Hodgkin’s lymphoma: experience from a tertiary cancer center in North East India

Authors

  • Munlima Hazarika Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Cliffton Sutnga Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Nithin Raj D. Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Partha S. Roy Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Satya S. Sarangi Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Raghavender Reddy Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Sreya Mallik Department of Pediatric and Medical Oncology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India
  • Anupam Sharma Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, Assam, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20230085

Keywords:

Pediatric Hodgkin’s lymphoma, Epidemiology, Response rate, Survival

Abstract

Background: Hodgkin’s lymphoma is a clonal malignant lymphoid proliferation, which originates from the germinal centers of B cells. This study was conducted to observe the socio-epidemiological profile of Hodgkin’s lymphoma in a tertiary cancer care centre from North East India.

Methods: All patients from 0 to 18 years of age group with histopathologically proven diagnosis of HL, presenting to department of medical & pediatric oncology at Dr. Bhubaneswar Borooah cancer Institute during the period January 2012 to December 2019 were included in the study. Clinical parameters assessed included age, sex, locality, occupation, presenting symptoms, performance status, site of lymph node involvement, treatment modality, response to treatment, progression free survival and overall survival.

Results: A total of 64 patients with histopathologically confirmed diagnosis of HL were registered in lymphoma joint clinic of BBCI from January 2012 to December 2019. The mean age was 12.68±4.71 years. Out of 64 patients, 54 (84.4%) belonged to rural areas and 10 patients (15.6%) to urban areas. Complete response was observed in 93.5% patient with limited risk disease, 73.24% with intermediate risk and 60% with advance stage. The overall survival and event free survival rates of 91% and 78.1%, respectively, were observed at 4 years.

Conclusions: This study provides insight to incidence, demographic profile, overall response rates and survival pattern with other secondary objectives such as complete response rate, compliance rate and toxicity assessment among children with Hodgkin lymphoma belonging to Northeastern India.

References

Küppers R. New insights in the biology of Hodgkin lymphoma. Hematol Am Soc Hematol Educ Program. 2012;2012:328-34.

Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90.

SEER Incidence Database. Available at: https://seer.cancer.gov/data/index.html. Accessed on 20 November 2021.

Dinshaw K, Pande S, Advani S, Ramakrishnan G, Nair C, Talvalkar G, et al. Pediatric Hodgkin’s disease in India. J Clin Oncol. 2016;3(12):162-5.

Dinand V, Arya LS. Epidemiology of childhood Hodgkins disease: is it different in developing countries? Indian Pediatr. 2006;43(2):141-7.

Schellong G, Pötter R, Brämswig J, Wagner W, Prott FJ, Dörffel W, et al. High cure rates and reduced long-term toxicity in pediatric Hodgkin’s disease: the German-Austrian multicenter trial DAL-HD-90. The German-Austrian Pediatric Hodgkin’s Disease Study Group. J Clin Oncol Off J Am Soc Clin Oncol. 1999; 17(12):3736-44.

Pritchard-Jones K, Kaatsch P, Steliarova-Foucher E, Stiller CA, Coebergh JWW. Cancer in children and adolescents in Europe: developments over 20 years and future challenges. Eur J Cancer Oxf Eng. 2006;42(13): 2183-90.

Baez F, Ocampo E, Conter V, Flores A, Gutierrez T, Malta A, et al. Treatment of childhood Hodgkin’s disease with COPP or COPP-ABV (hybrid) without radiotherapy in Nicaragua. Ann Oncol Off J Eur Soc Med Oncol. 1997;8(3):247-50.

Boo YL, Ting HSY, Yap DFS, Toh SG, Lim SM. Clinical features and treatment outcomes of Hodgkin lymphoma: A retrospective review in a Malaysian tertiary hospital. Blood Res. 2019;54(3):210-7.

Thomas RK, Re D, Zander T, Wolf J, Diehl V. Epidemiology and etiology of Hodgkin’s lymphoma. Ann Oncol Off J Eur Soc Med Oncol. 2002;13(4):147-52.

Stefan DC, Stones D. How much does it cost to treat children with Hodgkin lymphoma in Africa? Leuk Lymphoma. 2009;50(2):196-9.

Friedmann AM, Hudson MM, Weinstein HJ, Donaldson SS, Kun L, Tarbell NJ, et al. Treatment of unfavorable childhood Hodgkin’s disease with VEPA and low-dose, involved-field radiation. J Am Soc Clin Oncol. 2002;20(14):3088-94.

Engel M, Essop MF, Close P, Hartley P, Pallesen G, Sinclair-Smith C. Improved prognosis of Epstein-Barr virus associated childhood Hodgkin’s lymphoma: study of 47 South African cases. J Clin Pathol. 2000; 53(3):182-6.

Biasoli I, Castro N, Delamain M, Silveira T, Farley J, Pinto Simões B, et al. Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients-An analysis from the Brazilian Hodgkin Lymphoma Registry. Int J Cancer. 2018;142(5):883-90.

Maddi RN, Linga VG, Iyer KK, Chowdary JS, Gundeti S, Digumarti R, et al. Clinical profile and outcome of adult Hodgkin lymphoma: Experience from a tertiary care institution. Indian J Med Paediatr Oncol. 2015; 36(4):255-60.

Bazzeh F, Rihani R, Howard S, Sultan I. Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988-2005: an analysis of 21 734 cases. Leuk Lymphoma. 2010;51(12):2198-207.

Shafi RG, Al-Mansour MM, Kanfar SS, Al Hashmi H, Alsaeed A, Al-Foheidi M, et al. Hodgkin Lymphoma Outcome: A Retrospective Study from 3 Tertiary Centers in Saudi Arabia. Oncol Res Treat. 2017;40(5): 288-92.

Avagyan A, Danielyan S, Voskanyan A, Sargsyan L, Hakobyan L, Zohrabyan D, et al. Treating Adults with Hodgkin Lymphoma in the Developing World: a Hospital-Based Cohort Study from Armenia. Asian Pac J Cancer Prev APJCP. 2016;17(1):101-4.

Shanbhag S, Ambinder R. Hodgkin Lymphoma: a review and update on recent progress. CA Cancer J Clin. 2018;68(2):116-32.

Jain H, Sengar M, Nair R, Menon H, Laskar S, Shet T, et al. Treatment results in advanced stage Hodgkin’s lymphoma: A retrospective study. J Postgrad Med. 2015;61(2):88.

Johnson P, Federico M, Kirkwood A, Fosså A, Berkahn L, Carella A, et al. Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin’s Lymphoma. NEJM. 2021;10:1056-9.

Meyer RM, Gospodarowicz MK, Connors JM, Pearcey RG, Wells WA, Winter JN, et al. ABVD Alone versus Radiation-Based Therapy in Limited-Stage Hodgkin’s Lymphoma. NEJM. 2021;10:1061-5.

Gallamini A, Tarella C, Viviani S, Rossi A, Patti C, Mulé A, et al. Early Chemotherapy Intensification With Escalated BEACOPP in patients with advanced-stage Hodgkin lymphoma with a positive interim positron emission tomography/computed tomography scan after two ABVD Cycles. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36(5):454-62.

Duggan DB, Petroni GR, Johnson JL, Glick JH, Fisher RI, Connors JM, et al. Randomized comparison of ABVD and MOPP/ABV hybrid for the treatment of advanced Hodgkin’s disease: report of an intergroup trial. J Clin Oncol Off J Am Soc Clin Oncol. 2003; 21(4):607-14.

Spinner MA, Advani RH. Risk-adapted therapy for advanced-stage Hodgkin lymphoma. Hematology. 2018 Nov 30;2018(1):200-6.

Gobbi PG, Levis A, Chisesi T, Broglia C, Vitolo U, Stelitano C, et al. ABVD versus modified stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced-stage Hodgkin’s lymphoma: final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi. J Clin Oncol Off J Am Soc Clin Oncol. 2005;23(36): 9198-207.

Hoskin PJ, Lowry L, Horwich A, Jack A, Mead B, Hancock BW, et al. Randomized comparison of the stanford V regimen and ABVD in the treatment of advanced Hodgkin’s Lymphoma: United Kingdom National Cancer Research Institute Lymphoma Group Study. J Clin Oncol Off J Am Soc Clin Oncol. 2009; 27(32):5390-6.

Chow LML, Nathan PC, Hodgson DC, Jenkin D, Weitzman S, Grant RM, et al. Survival and Late Effects in Children With Hodgkin’s Lymphoma Treated With MOPP/ABV and Low-Dose, Extended-Field Irradiation. J Clin Oncol. 2006;24(36):5735-41.

Stieglitz E, Dinh T, Phelps AS, Pampaloni MH, Olshen AB, Robbins E. ABVD Without radiation for newly diagnosed pediatric and young adult patients with Hodgkin lymphoma: a single center retrospective analysis of 28 consecutive patients. J Pediatr Hematol Oncol. 2018;40(4):290-4.

Bhethanabhotla S, Jain S, Kapoor G, Mahajan A, Chopra A, Vishnubhatla S, et al. Outcome of pediatric advanced Hodgkin lymphoma treated with ABVD and predictors of inferior survival: a multicenter study of 186 patients. Leuk Lymphoma. 2017;58(7):1617-23.

Marr KC, Connors JM, Savage KJ, Goddard KJ, Deyell RJ. ABVD chemotherapy with reduced radiation therapy rates in children, adolescents and young adults with all stages of Hodgkin lymphoma. Ann Oncol. 2017;28(4):849-54.

de Armas S, Huertas-Ayala C, Chan RY, Chi Y-Y, Huh WW, Termuhlen A, et al. Survival of pediatric Hodgkin lymphoma patients treated with doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) at a single institution. Pediatr Blood Cancer. 2022;3: e29601.

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Published

2023-01-24

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Original Research Articles