Jain, S, Kapoor, G and Bajpai, R (2016) ABVD-Based Therapy for Hodgkin Lymphoma in Children and Adolescents: Lessons Learnt in a Tertiary Care Oncology Center in a Developing Country. Pediatric Blood and Cancer, 63 (6). 1024 - 1030.

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Abstract

Background
As Hodgkin lymphoma (HL) is a highly curable malignancy, most current pediatric trials focus on strategies aimed at reducing late effects of therapy. We report our results with doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) therapy.

Procedure
We retrospectively analyzed 17 years (1996–2013) data of patients ≤18 years of age with HL. All patients received ABVD chemotherapy and involved field radiotherapy (IFRT) was reserved for those with bulky disease or partial response. The analysis was carried out to assess overall survival (OS) and freedom from treatment failure (FFTF) and factors predicting the events.

Results
Of 167 eligible patients, 72 (43.1%) had B symptoms, 28 (16.7%) had bulky disease, 31 (18.6%) had >4 lymph node regions, and 53 (31.8%) had advanced disease (stages III and IV). In all, 87% patients received six cycles of ABVD and IFRT was administered to 51 (30.5%) patients. The 5‐year OS and FFTF were 95.9% and 79%, respectively, and were similar in patients treated with or without IFRT. On multivariable analysis, advanced disease (stages III and IV), involvement of >4 lymph node regions, and serum lactate dehydrogenase (LDH) ≥500 IU/l at diagnosis were statistically significant factors for FFTF (P = 0.03, 0.003, 0.048, respectively).

Conclusions
The excellent survival of HL patients in the setting of a developing country reported in this retrospective analysis warrants treatment reduction, especially for early‐stage patients. The use of risk‐ and response‐based stratification incorporating disease stage, involved lymph node regions, and serum LDH, along with fluorodeoxyglucose‐positron emission tomography‐based response, may guide development of effective and less toxic protocols.

Item Type: Article
Additional Information: The final version of this publication is available online at https://onlinelibrary.wiley.com/doi/full/10.1002/pbc.25935
Uncontrolled Keywords: Chemotherapy, Hodgkin lymphoma, pediatrics, radiotherapy, staging
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Divisions: Faculty of Medicine and Health Sciences > Primary Care Health Sciences
Related URLs:
Depositing User: Symplectic
Date Deposited: 08 Mar 2019 11:02
Last Modified: 08 Mar 2019 15:06
URI: http://eprints.keele.ac.uk/id/eprint/6036

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