Related Experiment Video
Updated: Mar 29, 2026
Selecting Multiple Biomarker Subsets with Similarly Effective Binary Classification Performances
Published on: October 11, 2018
The prognostic value of biological markers in paediatric Hodgkin lymphoma
Piero Farruggia1, Giuseppe Puccio2, Alessandra Sala3
1Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy.
Insights
Prognostic markers like elevated platelets, eosinophils, and ferritin, along with stage IV, can predict outcomes in pediatric Hodgkin lymphoma patients. These factors help classify patients into risk subgroups for better treatment strategies.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Biomarkers
Background:
- Prognostic value of biological and inflammatory markers in Hodgkin lymphoma (HL) is often proposed but rarely validated in pediatric patients.
- This study investigates the significance of these markers in a large cohort of 769 children with HL.
Purpose of the Study:
- To explore the prognostic significance of various biological and inflammatory markers at diagnosis in pediatric Hodgkin lymphoma.
- To identify validated markers that can predict outcomes in children with HL.
Main Methods:
- Utilized data from 769 pediatric HL patients enrolled in the A.I.E.O.P. trial LH2004.
- Patients were treated with curative intent using ABVD or hybrid COPP/ABV regimens between June 2004 and April 2014.
- Multivariate analysis was performed to assess the prognostic value of different markers.
Main Results:
- Elevated platelets, eosinophils, and ferritin levels, along with stage IV disease, were associated with significantly lower 5-year freedom from progression survival.
- Stage IV and eosinophils retained their predictive value irrespective of interim positron emission tomography (PET) results.
- These four markers (stage IV, platelets, eosinophils, ferritin) can stratify patients into distinct outcome groups.
Conclusions:
- A combination of four simple markers—stage IV, elevated platelets, ferritin, and eosinophils—can effectively classify pediatric Hodgkin lymphoma patients into subgroups with significantly different prognoses.
- This stratification aids in tailoring treatment and managing patient expectations based on risk.
Background:
Many biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children.
Patients And Methods:
By using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens.
Results:
On multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography.
Conclusion:
Using the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes.
