Treatment results of children with Hodgkin’s disease (HD) according to protocols DAL-HD and GPOH-HD
Margarita B. Belogurova1,2, Galina G. Radulesku1,2, Tatyana D. Viktorovich1,2, Emilia D. Chavpetsova2, Ludmila I. Shats1,2, Yulia V. Dinikina1
1St. Petersburg State Pediatric Medical Academy, Division of Oncology with a course of radiodiagnostics and radiotherapy;
2City Clinical Hospital №31, Department of Pediatric Oncology and Hematology, St. Petersburg, Russia
Margarita B. Belogurova, City Clinical Hospital №31, Department of Pediatric Oncology and Hematology, St. Petersburg, 197110, Russia
According to the data of the population-based Cancer Registry 2008, the structure of oncopediatric morbidity in SPb in the age group of 10–14 years (y) is most frequently malignant lymphoma (30.7%), both for girls and boys.
Sixty-four primary patients (pts) with HD were treated from 1992 to 2002 according to the following protocols: DAL-HD-90, GPOH-HD-95 (60 pts) and GPOH-HD-2002 (4 pts). The median age was 14 y. Distribution according to stages was as follows: Stages I–II were diagnosed in 46 pts (72%), 18 pts (28%) had advanced HD. The ratio of boys to girls in the group up to 11 y was 3.5:1; after 11 y both sexes were affected equally. Diagnosis was confirmed by histology (100%) and immunohistochemistry (52%). In our pts nodular sclerosis was predominant (81%). In children under 7 y a mixed cellularity variant was more frequent. In GPOH-HD-2002 protocol procarbazine was replaced by dacarbazine to decrease the adverse effects on the male reproductive system.
The CR was achieved in 61 pts (95.3%). In terms of medical observation from 8 to 210 months OS - 94.8% ± 2.89 and did not change after 29 months. RFS and EFS were 96.5% ± 2.37 and 92.1 ± 3.39 respectively. All events were registered within a period of 11 months.
During chemotherapy early toxic effects were minimal: mucositis, duodenal ulcer, and neuropathy. Late complications of radiotherapy – muscle atrophy in area of irradiation (2 cases) and tumors of thyroid gland (2 cases) – were revealed in terms of 2 to 8 years.
Hodgkin’s disease in children can be considered as a practically curable disease with moderate intensive treatment and low toxicity.
Hodgkin’s disease, children, chemotherapy, fertility