Hodgkin's disease in Indian children: Outcome with chemotherapy alone

Autor: Vasantha Thavaraj, Tribhuvan S. Vats, Ramesh Dawar, Rajvir Singh, Goura Kishor Rath, Laxman Singh Arya, Veronique Dinand, Sameer Bakhshi
Rok vydání: 2005
Předmět:
Zdroj: Pediatric Blood & Cancer. 46:26-34
ISSN: 1545-5017
1545-5009
DOI: 10.1002/pbc.20157
Popis: New Delhi, were treated with eight cycles of COPP, and the OS was less than 70%. From 1991 onwards, we have opted for an alternating combination of COPP with ABVD [14] without additional radiotherapy in order to avoid late affects of irradiation in growing children. We administered eight cycles of chemotherapy even to early stage disease in order to know the risk factors involved and thus adjust the treatment plan in the future. In this report, we analyzed a Background. To assess the efficacy of chemotherapy alone, using four cycles of COPP alternating with four cycles of ABVD in all stages of childhood Hodgkin’s disease (HD). Procedure. Between January 1991 and February 2001, 148 previously untreated patients were investigated, treated, and analyzed for remission and survival. Results. There were 134 boys and 14 girls with a median age of 8 years, 75% were less than 10 years old. 63.5% had advanced stage disease (IIB–IV). B symptoms were present in 54.4% of cases; bulky mediastinal mass in 18 cases (12.2%); spleen and bone marrow involvement in 22 (14.9%) and four cases (2.7%), respectively. Mixed cellularity (MC) subtype was found in 86.0%. Response to treatment was evaluated in 133 patients: complete remission (CR) was achieved in 121 patients (91.0%), partial remission (PR) in seven (5.3%), progression occurred in two (1.5%), and three (2.3%) died on therapy. Four patients with mediastinal residual disease were given additional involved field radiotherapy. Out of 111 patients analyzable, five (4.5%) have relapsed 6–30 months after completing chemotherapy, and were treated with additional cycles of ABVD and lowdose involved field radiotherapy. The 5-year actuarial overall survival (OS) and event-free survival (EFS) are 91.5 and 87.9%, respectively. Advanced stage, B symptoms, anemia, spleen, and marrow involvement were adverse prognostic factors for survival. Conclusions. Chemotherapy alone with alternating COPP/ABVD, without additional radiotherapy, provides high rates of durable remission and is an effective therapy in childhood HD, even in case of large mediastinal mass and peripheral or abdominal bulky disease. Pediatr Blood Cancer 2006;46: 26–34. 2005 Wiley-Liss, Inc.
Databáze: OpenAIRE
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