Treatment of lymphocyte depletion Hodgkin's disease in children

Lymphocyte depletion Hodgkin's disease (LDHD) was diagnosed in 8 of 40 children with Hodgkin's disease treated from July 1969 to September 1976. All of the children received conventional radiotherapy and combination chemotherapy with mustine, vinblastine, procarbazine, and prednisone (MVPP). In LDHD children the disease was associated with severe anemia, splenomegaly presence of mediastinal enlargement, and dissemination at the time of diagnosis. Three children with LDHD did not achieve remission and died with uncontrolled disease. In two others, relapses occurred and led to death in one. Only three children remain in their first remission. Only 3 of 32 patients with non-LDHD relapsed and entered second remission. All 32 patients were free of disease at the time of evaluation, with mean survival of 88.2 months. We conclude that LDHD in childhood is frequently associated with clinically advanced disease and still has a bad prognosis. Alternative approaches to its therapy are needed.