Hodgkin's disease in childhood

A retrospective study of 116 children with Hodgkin's disease diagnosed in the period 1935-1970 was undertaken to assess the prognostic role of histopathologic classiciation and clinical extent of the disease. The ages of the 80 boys and 36 girls ranged from 2.5 years to 15.0 years (mean, 10.0 years). The histopathologic diagnosis by lymph node biopsy revealed lymphocyte predominance in 22, nodular sclerosis in 67, mixed cellularity in 24, and lymphocyte depletion in 3. Within the subgroup of nodular sclerosis, 47 biopsies had classic well-developed collagenous bands, whereas 20 were in the cellular phase (10 without collagenous bands and 10 with minimal collagen). The clinical extent of disease was determined. There were 33 patients with Stage I disease, 38 with Stage IIA, 12 with Stage IIB, 24 with Stage III, and 9 with Stage IV. Survival correlated with histopathologic type and clinical stage, but not with age or sex. Survival was not dependent on the degree of collagenization in nodular sclerosis. There were 28 patients who survived for more than 10 years. Four of these 29 subsequently died owing to acute myelomonocytic leukemia, carcinoma of the breast, sepsis, and progression of Hodgkin's disease, respectively. Neoplasms developed in two other long-term survivors (thyroid carcinoma in one, and multiple basal cell carcinomas in the other).