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Kendel NE, Stanek JR, Willen FK, Audino AN. Characterizing age-related differences in Hodgkin lymphoma in children, adolescents and young adults. Pediatr Hematol Oncol 2024:1-10. [PMID: 38587477 DOI: 10.1080/08880018.2024.2337627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/25/2024] [Indexed: 04/09/2024]
Abstract
Current studies describing younger children with Hodgkin lymphoma are limited by geographical region, small sample sizes and variable age groups. Although published data is lacking, there appears to be a trend toward a higher male to female ratio and a higher proportion of mixed cellularity subtype when compared to older cohorts. We performed a retrospective multicenter study utilizing the Pediatric Health Information System® database to evaluate patients aged 0-39 years with Hodgkin lymphoma. We identified 3,034 unique patients who met inclusion criteria. Younger age groups had a larger proportion of males, Hispanic/Latino ethnicity, and mixed cellularity subtype. Treatment-related complications, including mucositis, pain, bacterial infections, and thrombosis, were documented more frequently in older cohorts. We also found significant age-related differences in medical management. This study is the largest study evaluating age-related differences in patients with Hodgkin lymphomaand the first study to evaluate for differences in complicationsand supportive care management.
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Affiliation(s)
- Nicole E Kendel
- Department of PediatricHematology/Oncology, Akron Children's Hospital, Akron, Ohio, USA
| | - Joseph R Stanek
- Division of PediatricHematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Faye K Willen
- Division of PediatricHematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Anthony N Audino
- Division of PediatricHematology/Oncology, Nationwide Children's Hospital, Columbus, Ohio, USA
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Mahajan A, Bakhshi S, Seth R, Verma N, Mandal P, Singh M, Jain S, Radhakrishnan V, Kanvinde S, Arora RS, Dinand V, Kalra M, Taluja A, Mallick S, Kumar R, Chandra J. Hodgkin Lymphoma in Children Under 5 Years: Do They Behave Differently? J Pediatr Hematol Oncol 2022; 44:186-190. [PMID: 35293880 DOI: 10.1097/mph.0000000000002423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/15/2021] [Indexed: 01/09/2023]
Abstract
The median age of presentation for Hodgkin lymphoma (HL) is lower in developing countries with a higher proportion under 5 years of age possibly attributable to the high prevalence of Epstein-Barr virus-driven disease. It is unclear whether the clinical presentation and outcomes of this cohort are different with concern regarding late effects being most pronounced in this age group. We report the outcome of children under 5 years of age enrolled in the InPOG-HL-15-01, the first multicentric collaborative study for newly diagnosed children and adolescents with HL from India. Thirty-five (9%) of the study population was younger than 5 years with a striking male preponderance of 34:1. They were less likely to have bulky disease, mediastinal or splenic involvement. The outcomes appear to be at least as favorable as in the older patient group. Efforts need to be made to evolve treatment strategies that spare this very young cohort from potential late effects.
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Affiliation(s)
- Amita Mahajan
- Department of Pediatric Oncology, Indraprastha Apollo Hospital
| | | | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences
| | - Nishant Verma
- Department of Pediatrics, King George's Medical University, Lucknow, Uttar Pradesh
| | - Piali Mandal
- Department of Pediatrics, Kalawati Saran Children's Hospital
| | - Manisha Singh
- Department of Medical and Pediatric Oncology, Mahavir Cancer Sansthan, Patna, Bihar
| | - Sandeep Jain
- Department of Pediatric Oncology, Rajiv Gandhi Cancer Institute
| | | | - Shailesh Kanvinde
- Department of Pediatric Hematology Oncology, Deenanath Mangeshkar Hospital, Pune
| | - Raman S Arora
- Department of Pediatric Oncology, Max Super Specialty Hospital
| | - Veronique Dinand
- Palliative and Supportive Unit, BJ Wadia Hospital, Mumbai, Maharashtra, India
| | - Manas Kalra
- Department of Pediatric Oncology, Sir Ganga Ram Hospital
| | | | | | | | - Jagdish Chandra
- Department of Pediatrics, Kalawati Saran Children's Hospital
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YILMAZ E, ARSLAN M, AKYOL Ş, ÖZCAN A, ZARARSIZ G, ABDULREZZAK Ü, KONTAŞ O, CANÖZ Ö, ÜNAL E, KARAKÜKÇÜ M. Single-center experience of childhood Hodgkin lymphoma treated without radiotherapy. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2021. [DOI: 10.32322/jhsm.984394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Farruggia P, Puccio G, Locatelli F, Vetro M, Pillon M, Trizzino A, Sala A, Buffardi S, Garaventa A, Rossi F, Bianchi M, Zecca M, Pession A, Favre C, D’Amico S, Provenzi M, Zanazzo GA, Sau A, Santoro N, Mura R, Elia C, Casini T, Mascarin M, Burnelli R. Classical pediatric Hodgkin lymphoma in very young patients: the Italian experience. Leuk Lymphoma 2018; 60:696-702. [DOI: 10.1080/10428194.2018.1493732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Piero Farruggia
- Pediatric Hematology and Oncology Unit Oncology Department, A.R.N.A.S. Ospedali Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Giuseppe Puccio
- Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Francesco Locatelli
- Dipartimento di Oncoematologia Pediatrica, IRCCS Ospedale Bambino Gesù, Roma, University of Pavia, Italy
| | - Mariarita Vetro
- Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy
| | - Marta Pillon
- Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy
| | - Angela Trizzino
- Pediatric Hematology and Oncology Unit Oncology Department, A.R.N.A.S. Ospedali Civico Di Cristina e Benfratelli, Palermo, Italy
| | - Alessandra Sala
- Clinica Pediatrica, Universita’ Milano – Bicocca A.O. San Gerardo – Fondazione MBBM, Monza, Italy
| | - Salvatore Buffardi
- Dipartimento di Oncologia Pediatrica A.O. Santobono-Pausilipon, Napoli, Italy
| | - Alberto Garaventa
- Dipartimento di Ematologia e Oncologia Pediatrica, Istituto G. Gaslini, Genova, Italy
| | - Francesca Rossi
- Dipartimento di Pediatria II Ateneo di Napoli, Servizio di Oncologia Pediatrica, Napoli, Italy
| | - Maurizio Bianchi
- S.C. Oncoematologia Pediatria e Centro Trapianti, Ospedale Infantile Regina Margherita, Torino, Italy
| | - Marco Zecca
- Oncoematologia Pediatrica, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Andrea Pession
- Dipartimento di Oncoematologia Pediatrica, ‘Lalla Seragnoli’ Clinica Pediatrica Policlinico Sant’Orsola Malpighi, Bologna, Italy
| | - Claudio Favre
- Oncologia Clinica Pediatrica e Trapianto Midollo Osseo, Azienda Ospedaliera – Università, Pisa, Italy
| | | | - Massimo Provenzi
- Sezione Oncoematologia Pediatrica, Dipartimento di Pediatria, Ospedali Riuniti di Bergamo, Bergamo, Italy
| | - Giulio Andrea Zanazzo
- U.O. Emato-Oncologia Pediatrica, Università degli Studi di Trieste Osp.le Infantile Burlo Garofolo, Trieste, Italy
| | - Antonella Sau
- U.O. Oncoematologia Pediatrica, Ospedale Civile Spirito Santo, Pescara, Italy
| | - Nicola Santoro
- Unità Operativa Complessa di Oncologia ed Ematologia Oncologica Pediatrica-Policlinico, Bari, Italy
| | - Rosamaria Mura
- Oncoematologia Pediatrica e Patologia della coagulazione, Ospedale Regionale per le Microcitemie, Cagliari, Italy
| | - Caterina Elia
- S.S. Radioterapia Pediatrica e Area Giovani, IRCCS Centro di Riferimento Oncologico Aviano, Pordenone, Italy
| | - Tommaso Casini
- Dipartimento di Oncoematologia Pediatrica A.O.U Meyer, Firenze, Italy
| | - Maurizio Mascarin
- S.S. Radioterapia Pediatrica e Area Giovani, IRCCS Centro di Riferimento Oncologico Aviano, Pordenone, Italy
| | - Roberta Burnelli
- Oncoematologia Pediatrica, Azienda Ospedaliera Universitaria Ospedale Sant’Anna, Ferrara, Italy
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Frew JA, Lewis J, Lucraft HH. The management of children with lymphomas. Clin Oncol (R Coll Radiol) 2012; 25:11-8. [PMID: 23231943 DOI: 10.1016/j.clon.2012.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 08/10/2012] [Accepted: 08/13/2012] [Indexed: 10/27/2022]
Abstract
Lymphomas account for 10-15% of all paediatric malignancies. They are highly curable with 5 year survival rates of up to 95% for Hodgkin lymphoma and 82% for non-Hodgkin lymphoma. These excellent results have focused recent attention on reducing the burden of treatment-related morbidity while maintaining the excellent outcomes. Lymphomas are highly radiosensitive and radiotherapy was used historically in the treatment of both paediatric Hodgkin and non-Hodgkin lymphomas. As the late effects of radiotherapy, including second tumours, were recognised, successive protocols seeking to minimise late effects were developed that reduced the use of radiotherapy. Current treatment protocols for non-Hodgkin lymphoma are chemotherapy based and radiotherapy has been virtually eliminated. In contrast, current paediatric Hodgkin lymphoma protocols continue to use radiotherapy as part of combined modality treatment, targeted according to risk factors and response and at the minimum effective dose. This article reviews the treatment of Hodgkin lymphoma in children with particular emphasis on the role of radiotherapy.
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Affiliation(s)
- J A Frew
- Northern Centre for Cancer Care, The Freeman Hospital, High Heaton, Newcastle-upon-Tyne, UK.
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Belgaumi A, Al-Kofide A, Joseph N, Jamil-Malik R, Khafaga Y, Sabbah R. Hodgkin lymphoma in very young children: Clinical characteristics and outcome of treatment. Leuk Lymphoma 2009; 49:910-6. [DOI: 10.1080/10428190801947492] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Sweetenham JW. Minimizing late effects in children and adults with Hodgkin lymphoma – The beginning of the end for radiation therapy. Leuk Lymphoma 2009; 49:839-40. [DOI: 10.1080/10428190801976624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Büyükpamukçu M, Varan A, Akyüz C, Atahan L, Özyar E, Kale G, Köksal Y, Kutluk T. The treatment of childhood Hodgkin lymphoma: improved survival in a developing country. Acta Oncol 2009; 48:44-51. [PMID: 18777215 DOI: 10.1080/02841860802310991] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND To evaluate the clinical characteristics, treatment regimens, and outcome of children with Hodgkin lymphoma in a developing country over a period of 34 years. METHODS This paper retrospectively evaluates the treatment and prognosis of 614 children with Hodgkin lymphoma disease between 1971 and 2005. All patients were treated with chemotherapy, and also received radiotherapy. RESULTS There were 452 males and 162 females with a median age of 8 years (2 to 21); 183 patients had B symptoms. There were 165, 185, 145, and 119 patients in stage I, II, III, and IV, respectively. Histopathologic subtypes were mixed cellularity (344 patients), nodular sclerosis (90), lymphocytic predominance (62), lymphocytic depletion (46), unclassified types (69), and nodular lymphocyte predominant Hodgkin lymphoma (3). Overall (OS) and event-free survival (EFS) rates were 83 and 60%, though OS rates varied according to chemotherapy protocol; age; presence of B symptoms, leukocytosis, anemia, and extranodal involvement; and stage at diagnosis. Over the years, the median age of patients increased, as did the frequency of the nodular sclerosing type of disease. CONCLUSIONS This is one of the largest series in a single center. The increase in the median age and in the frequency of the nodular-sclerosing type are thought to be related to the development status of Turkey. The ABVD protocol yielded the best survival rates and should be used for treatment of patients with Hodgkin lymphoma.
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