Pediatric Hodgkin lymphoma: epidemiologic characteristics and early treatment results in a new oncology center

Öz

OBJECTIVES To evaluate patient characteristics and treatment results of pediatric patients with Hodgkin lymphoma. METHODS Hodgkin lymphoma patients (9 males, 4 females; mean age 9.2±3.5; range 4 to 15 years) at pediatric age group (

Anahtar Kelimeler

• Hodgkin Disease,Lymphoma,Prognosis,Retrospective Studies,Survival Rate,Child

Pediatrik Hodgkin lenfoma: Yeni yapılanmakta olan bir onkoloji merkezinde epidemiyolojik özellikler ve erken tedavi sonuçları

Öz

AMAÇ Pediatrik Hodgkin lenfoma tanılı hastaların karakteristikleri ve tedavi yanıtlarının incelenmesi. GEREÇ VE YÖNTEM 2003-2006 yılları arasında Kocaeli Üniversitesi Pediatrik Onkoloji Grubu tarafından tedavi edilen Hodgkin lenfoma tanılı 18 yaş altı hastalar (9 erkek, 4 kız; ort. yaş 9.2±3.5; dağılım 4-15) geriye dönük olarak değerlendirildi. BULGULAR En sık saptanan histopatolojik alt tip (%54) mikst selüler Hodgkin lenfoma idi. Olguların %69'u erken evre hastalıkla (evre I, II) başvurmuşlardı. On iki olguya ABVD, bir hastaya ise OEPA/COPP rejimi uygulandı. Hastaların %83'ünde 2. kürden sonra tam yanıt elde edildi. Olguların 11'ine kemoterapi sonrası tutulu alan radyoterapisi, 2 olguya ise “bulky” bölgeye radyoterapi uygulandı. Radyoterapi dozları evreye ve kemoterapi cevabına göre değişmekle birlikte ortanca 2000 (1500-3000) cGy'di. Dört yıllık genel ve olaysız sağkalım oranları %87.5 olarak saptandı. SONUÇ Merkezimizde uygulanan evre ve KT yanıtına dayalı kombine tedavi modelimizin erken sonuçları, diğer merkezlerin sonuçlarıyla benzer oranda başarılıdır.

Anahtar Kelimeler

• Çocuk, Hodgkin hastalığı/ilaç tedavisi/patoloji/radyoterapi, prognoz, geriye dönük çalışma, sağkalım oranı

Kaynakça

1. 1. Pötter R. Paediatric Hodgkin’s disease. Eur J Cancer 1999;35(10):1466-76.
2. 2. Büyükpamukçu M, Atahan L, Ca¤lar M, Kutluk T, Akyüz C, Hazar V. Hodgkin’s disease in Turkish children: clinical characteristics and treatment results of 210 patients. Pediatr Hematol Oncol 1999;16(2):11 9 - 2 9 .
3. 3. Hudson MM, Onciu M, Donaldson SS. Hodgkin lymphoma. In: Pizzo PA, Poplack DG, editors. Principles and practice of pediatric oncology. 5th ed. Philedelphia: Lippincott Williams&Wilkins; 2005. p. 694-721.
4. 4. Oguz A, Karadeniz C, Okur FV, Citak EC, Pinarli FG, Bora H, et al. Prognostic factors and treatment outcome in childhood Hodgkin disease. Pediatr Blood Cancer 2005;45(5):670-5.
5. 5. Arya LS, Dinand V. Current strategies in the treatment of childhood Hodgkins disease. Indian Pediatr 2005;42(11):1115-28.
6. 6. Rühl U, Albrecht M, Dieckmann K, Lüders H, Marciniak H, Schellenberg D, et al. Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD 95 trial. Int J Radiat Oncol Biol Phys 2001;51(5):1209-18.
7. 7. Hsu SC, Metzger ML, Hudson MM, Pedrosa F, Lins M, Pedrosa M, et al. Comparison of treatment outcomes of childhood Hodgkin lymphoma in two US centers and a center in Recife, Brazil. Pediatr Blood Cancer 2007;49(2):139-44.
8. 8. Harris NL, Jaffe ES, Diebold J, Flandrin G, MullerHermelink HK, Vardiman J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Vi rginia, November 1997. J Clin Oncol 1999;17(12):3835-49.

9. 9. Hiçsönmez G, Büyükpamukçu M. Pediatric hematology and oncology in Turkey. Ph/o Forum 1994;1:4-8.
10. 10.Cavdar AO, Pamir A, Gözdafloglu S, Babacan E, Yavuz G, Unal E, et al. Hodgkin disease in children: clinicoepidemiologic and viral (Epstein-Barr virus) analyses. Med Pediatr Oncol 1999;32(1):18-24.
11. 11. Correa P, O'Conor GT. Epidemiologic patterns of Hodgkin’s disease. Int J Cancer 1971;8(2):192-201.
12. 12.Cavdar AO, Tacoy A, Babacan E, Gözdaflo¤lu S, Arcasoy A, Topuz U, et al. Hodgkin’s disease in Turkish children: a clinical and histopathologic analysis. J Natl Cancer Inst 1977;58(3):479-81.
13. 13. Sachdeva A, Wallace WHB. Hodgkin’s lymphomacurrent concepts. In: Agarwal BR, Perilongo G, Rogers P, Strahlendorf C, Eden OB, editors. International Society of Paediatric Oncology education book. 2005. p. 87-99.
14. 14. Norum J, Wist E. Hodgkin disease treated at the Tromsø regional hospital 1985-93. Diagnosis, treatment, prognosis, quality of life and costs of a decentralized treatment. [Article in Norwegian] Tidsskr Nor Laegeforen 1997;117(1):23-6. [Abstract]
15. 15.Chang ET, Zheng T, Weir EG, Borowitz M, Mann RB, Spiegelman D, et al. Childhood social environment and Hodgkin’s lymphoma: new findings from a population-based case-control study. Cancer Epidemiol Biomarkers Prev 2004;13(8):1361-70.
16. 16. Lanzkowsky P. Pediatric hematology and oncology. 4th ed. Burlington, MA: Elsevier Academic Press; 2005. p. 453-90.
17. 17.Carbone PP, Kaplan HS, Musshoff K, Smithers DW, Tubiana M. Report of the Committee on Hodgkin’s Disease Staging Classification. Cancer Res 1971;31(11):1860-1.
18. 18. Lukes RJ, Butler JJ. The pathology and nomenclature of Hodgkin’s disease. Cancer Res 1966;26(6):1063-83.
19. 19. Kung FH, Schwartz CL, Ferree CR, London WB, Ternberg JL, Behm FG, et al. POG 8625: a randomized trial comparing chemotherapy with chemoradiotherapy for children and adolescents with Stages I, IIA, IIIA1 Hodgkin Disease: a report from the Children's Oncology Group. J Pediatr Hematol Oncol 2006;28(6):362-8.
20. 20.Carde P, Koscielny S, Franklin J, Axdorph U, Raemaekers J, Diehl V, et al. Early response to chemotherapy: a surrogate for final outcome of Hodgkin’s disease patients that should influence initial treatment length and intensity? Ann Oncol 2002;13 Suppl 1:86-91.
21. 21. Nachman JB, Sposto R, Herzog P, Gilchrist GS, Wolden SL, Thomson J, et al. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 2002;20(18):3765-71.
22. 22. Henry-Amar M, Joly F. Late complications after H o d g k i n’s disease. Ann Oncol 1996;7 Suppl 4:11 5 - 2 6 .
23. 2 3 . H u dson MM, Poquette CA, Lee J, Greenwald CA, Shah A, Luo X, et al. Increased mortality after successful treatment for Hodgkin’s disease. J Clin Oncol 1998;16(11):3592-600.
24. 24. Herbertson R, Hancock BW. Hodgkin Lymphoma in adolescents. Cancer Treat Rev 2005;31(5):339-60.
25. 25.Corapçioglu F, Sarper N, Berk F, Sahin T, Zengin E, Demir H. Evaluation of anthracycline-induced early left ventricular dysfunction in children with cancer: a comparative study with echocardiography and multigated radionuclide angiography. Pediatr Hematol Oncol 2006;23(1):71-80.
26. 26. Treatment strategies for pediatric nodular lymphocyte predominant Hodgkin’s lymphoma. Leuk Ly m p h 2006;47(8):1450-1.