[Hodgkin's disease in childhood].
Only in these latest years has been possible to consider Hodgkin disease (HD) as a neoplastic syndrome, thank of immunohistochemistry and cytogenetic techniques which have confirmed the monoclonal origin of typical cellular marker of disease: the Reed-Sternberg cell (R-S cell). Interesting associations have been observed between children suffering from HD and the positivity of EBV antigen above all in the socio-economically developed countries. The histopathologic classification of HD is divided in four sub-types, with different incidence in the pediatric age: the nodular sclerosis and the mixed cellularity are more rap-presented than the lymphocyte predominance and mostly the lymphocyte depletion. Histopathologic classification is essential for the prognosis and a correct therapeutic approach to disease. The management of HD is based on chemotherapy and radiotherapy associated; the results of treatment are more and more encouraging with a global survival over 95%. Sequelae of treatment are reduced in modern therapeutic trials: in particularly injury to somatic growth, cardiopulmonary system, gonadal and thyroid functionality is reduced by using low dose and involved fields for the early stage patients. The most important sequela in children treated for HD is the risk to developed a second malignant neoplasm; in particularly acute nonlymphocytic leukemia and non Hodgkin's lymphoma. In patients treated with radiotherapy alone increase the risk to develop solid tumors like sarcomas and carcinomas, which can appears several years after diagnosis.
Grazia
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Divisione di Pediatria Oncologica, Università degli Studi di Torino.
Tarizzo
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PL
Bianchi
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Savino
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Madon
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D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004358:Drug Therapy; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008214:Lymphocytes / Q000737:chemistry; D008297:Male; D016609:Neoplasms, Second Primary / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects; D016539:Reed-Sternberg Cells / Q000276:immunology
La malattia di Hodgkin in età pediatrica.