Treatment results of Hodgkin's disease in Indian children
Related Experiment Videos
G Kapoor1, S H Advani, K A Dinshaw
1Department of Medical Oncology, Tata Memorial Hospital, Parel, Bombay, India.
Insights
Pediatric Hodgkin's disease in India showed a high complete response rate (89%) with combination chemotherapy and radiotherapy. Seven-year survival reached 73%, indicating effective treatment for childhood Hodgkin's lymphoma.
Area of Science:
- Pediatric Oncology
- Hematology
- Clinical Research
Background:
- Hodgkin's disease is a significant malignancy in children.
- Understanding treatment outcomes in pediatric populations is crucial for improving survival rates.
- Data from developing countries like India are essential for global health insights.
Purpose of the Study:
- To evaluate the clinicopathologic characteristics, treatment response, and survival outcomes of pediatric Hodgkin's disease.
- To analyze treatment protocols including combination chemotherapy (COPP, COPP/ABVD, ABVD) and involved field radiotherapy.
- To assess the impact of disease stage, B symptoms, and bulky disease on treatment efficacy.
Main Methods:
- Retrospective analysis of 187 pediatric patients (under 15 years) with Hodgkin's disease treated between 1985-1990.
- Evaluation of clinicopathologic features, treatment regimens, and response in 147 patients.
- Calculation of survival rates using actuarial methods with a median follow-up of 36 months.
Main Results:
- A total of 187 patients were included, with a male-to-female ratio of 6:1.
- Most patients (63%) presented with Stage I or II disease; mixed cellularity was the most common subtype (65%).
- Complete response was achieved in 89% of patients, with an 11% relapse rate. Seven-year actuarial survival was 73% and event-free survival was 64%.
Conclusions:
- Combination chemotherapy and involved field radiotherapy demonstrate high efficacy in treating pediatric Hodgkin's disease in India.
- The observed survival rates are comparable to those reported in developed countries, highlighting successful management strategies.
- Further research can focus on long-term outcomes and potential treatment modifications for improved event-free survival.
Abstract:
This is a retrospective study of Hodgkin's disease in children less than 15 years of age who were registered at Tata Memorial Hospital in India from January 1985 through December 1990. Clinicopathologic characteristics and response were evaluated in 147 patients and survival was calculated in 187. There were 126 boys and 21 girls (6:1). All patients were treated with combination chemotherapy and involved field radiotherapy. The COPP schedule was given to 108 patients. COPP/ABVD to 33, and ABVD to 6. Ninety-three patients (63%) had stage I or II disease and 54 (37%) had stage III or IV disease. B symptoms were observed in 65 patients (56%) and bulky disease in 40 (27%). Histologically, the most common subtype was mixed cellularity, seen in 95 patients (65%). Complete response was observed in 136 (89%), partial response in 6 (4%), and there were 4 treatment-related deaths. Relapse has been observed in 11%. Seven-year actuarial survival was 73% and event-free survival was 64%. Median survival has not yet been reached, with a median follow-up of 36 months.