Response and relapses in pediatric Hodgkin's Lymphoma treated with chemotherapy alone

Aims: The aims of this study were to analyze the sociodemographic profile, disease characteristics, event-free survival (EFS), overall survival (OS), and risk factors for relapse in patients with Hodgkin's lymphoma (HL) treated with only chemotherapy as per unit protocol. Subject and Methods: Case records of children with HL diagnosed and treated at our center between January 2005 and December 2014 were retrospectively analyzed. Results: A total of 90 patients with mean age of 8.13 ± 2.65 years (median age 8 years; range 4.5–15 years) were diagnosed and treated for HL during the study period. Male-to-female ratio was 7.2:1. Almost 12.2% and 87.8% of patients had early and advanced stage disease, respectively. B symptoms were present in 87.8% of patients. Mean duration of symptoms was 9.66 ± 6.30 months (median 8 months; range 2–36 months). Mixed cellularity was the most common histologic type. Multiagent chemotherapy was mainstay of treatment. OS and EFS were 88.8% and 84.5%, respectively. OS in patients with or without bulky disease was 53.3% and 92.2%, respectively. Older age (≥10 years), presence of bulky disease, low hemoglobin (≤7.0 g/dl), and high leukocyte count (≥12000/mm3) at the time of diagnosis, and protocol used (cyclophosphamide, vincristine, procarbazine, and prednisone) were the risk factors for relapse. Conclusions: Our patient population had younger age, advanced disease, more B symptoms, and bulky disease. Still, we achieved good OS and EFS with chemotherapy-alone protocols. Patients with bulky disease had poor OS and EFS. If radiotherapy is included in the protocol for bulky disease, the survival rates can be improved further.