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Hodgkin Lymphoma in Children Under 5 Years: Do They Behave Differently?
Amita Mahajan1, Sameer Bakhshi2, Rachna Seth3
1Department of Pediatric Oncology, Indraprastha Apollo Hospital.
Insights
Children under 5 with Hodgkin lymphoma (HL) in India show a male predominance and less advanced disease. Their outcomes are favorable, but treatment strategies should minimize late effects in this young Hodgkin lymphoma cohort.
Area of Science:
- Pediatric Oncology
- Hematology
- Epidemiology
Background:
- Hodgkin lymphoma (HL) presents at a younger median age in developing nations, with a notable proportion under 5 years old.
- Epstein-Barr virus (EBV) is a suspected factor in the higher prevalence of pediatric HL in this age group.
- Concerns exist regarding the distinct clinical presentation and potential long-term effects of HL in very young children.
Purpose of the Study:
- To report the outcomes of children under 5 years diagnosed with Hodgkin lymphoma (HL) in India.
- To analyze the clinical characteristics and treatment results for this specific pediatric cohort.
- To inform the development of tailored treatment strategies for young HL patients.
Main Methods:
- Analysis of data from the InPOG-HL-15-01 multicentric collaborative study.
- Inclusion of newly diagnosed children and adolescents with HL from India.
- Focus on the subgroup of patients younger than 5 years.
Main Results:
- Thirty-five patients (9%) were under 5 years old, with a significant male preponderance (34:1).
- This young cohort presented less frequently with bulky disease, mediastinal, or splenic involvement.
- Outcomes for children under 5 were comparable to those of older pediatric HL patients.
Conclusions:
- Children under 5 with Hodgkin lymphoma in India have a distinct demographic profile and clinical presentation.
- The outcomes for this very young cohort appear favorable compared to older children.
- Future treatment strategies should prioritize minimizing potential late effects in this vulnerable pediatric population.
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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