Related Experiment Videos
[Hodgkin's disease in childhood]
G Grazia1, P L Tarizzo, M Bianchi
1Divisione di Pediatria Oncologica, Università degli Studi di Torino.
Insights
Hodgkin disease (HD) is a neoplastic syndrome confirmed by advanced techniques. Modern treatments offer over 95% survival, with reduced side effects and a focus on preventing secondary cancers.
Area of Science:
- Oncology
- Immunology
- Genetics
Context:
- Hodgkin disease (HD) is increasingly recognized as a neoplastic syndrome.
- Advances in immunohistochemistry and cytogenetics confirm the monoclonal origin of Reed-Sternberg cells, the hallmark of HD.
- Associations between pediatric HD and Epstein-Barr virus (EBV) positivity are noted, particularly in developed nations.
Purpose:
- To review the histopathologic classification of Hodgkin disease.
- To discuss the current management strategies for pediatric Hodgkin disease.
- To evaluate treatment outcomes, sequelae, and long-term risks associated with Hodgkin disease therapy.
Summary:
- Hodgkin disease is classified into four subtypes, with nodular sclerosis and mixed cellularity being more common in children.
- Treatment involves combined chemotherapy and radiotherapy, yielding survival rates exceeding 95%.
- Modern therapeutic approaches minimize treatment-related sequelae, such as impaired growth and organ function, by using lower doses and targeted radiation fields.
Impact:
- Improved understanding of HD pathogenesis and classification aids in accurate prognosis and tailored therapeutic strategies.
- High survival rates and reduced treatment toxicity in pediatric Hodgkin disease patients are achieved.
- Long-term surveillance is crucial to monitor for and manage potential secondary malignancies, including leukemia and solid tumors, following treatment for Hodgkin disease.
Abstract:
Only in these latest years has been possible to consider Hodgkin disease (HD) as a neoplastic syndrome, thank of immunohistochemistry and cytogenetic techniques which have confirmed the monoclonal origin of typical cellular marker of disease: the Reed-Sternberg cell (R-S cell). Interesting associations have been observed between children suffering from HD and the positivity of EBV antigen above all in the socio-economically developed countries. The histopathologic classification of HD is divided in four sub-types, with different incidence in the pediatric age: the nodular sclerosis and the mixed cellularity are more rap-presented than the lymphocyte predominance and mostly the lymphocyte depletion. Histopathologic classification is essential for the prognosis and a correct therapeutic approach to disease. The management of HD is based on chemotherapy and radiotherapy associated; the results of treatment are more and more encouraging with a global survival over 95%. Sequelae of treatment are reduced in modern therapeutic trials: in particularly injury to somatic growth, cardiopulmonary system, gonadal and thyroid functionality is reduced by using low dose and involved fields for the early stage patients. The most important sequela in children treated for HD is the risk to developed a second malignant neoplasm; in particularly acute nonlymphocytic leukemia and non Hodgkin's lymphoma. In patients treated with radiotherapy alone increase the risk to develop solid tumors like sarcomas and carcinomas, which can appears several years after diagnosis.