title: Lymphocyte-predominant Hodgkin's lymphoma in children: therapeutic abstention after initial lymph node resection--a Study of the French Society of Pediatric Oncology.
abstract: OBJECTIVE
  To clarify treatment strategy for lymphocyte-predominant Hodgkin's lymphoma (LPHL), the French Society of Pediatric Oncology initiated a prospective, nonrandomized study in 1988. Patients received either standard treatment for Hodgkin's lymphoma or were not treated beyond initial adenectomy.
  
  
  METHODS
  From 1988 to 1998, 27 patients were available for study. Twenty-four patients were male, and median age was 10 years (range, 4 to 16 years). Twenty-two, two, and three patients had stage I, II, and III disease, respectively. Thirteen patients (stage I, n = 11; stage III, n = 2) received no further treatment after initial surgical adenectomy (SA). Fourteen patients received combined treatment (CT; n = 10), involved-field radiotherapy alone (n = 1), or chemotherapy alone (n = 3). The two groups were comparable for clinical status, treatment, and follow-up.
  
  
  RESULTS
  Twenty-three of 27 patients achieved complete remission (CR). With a median follow-up time of 70 months (range, 32 to 214 months), overall survival to date is 100%, and overall event-free survival (EFS) is 69% +/- 10% (SA, 42% +/- 16%; CT, 90% +/- 8.6%; P <.04). If we considered only the patients in CR after initial surgery (n = 12), EFS was no longer significantly different between the two groups. Patients with residual mass after initial surgery (n = 15) had worse EFS if they did not receive complementary treatment (P <.05).
  
  
  CONCLUSIONS
  Although based on a small number of patients, our study showed that (1). no further therapy is a valid therapeutic approach in LPHL patient in CR after initial lymph node resection, and (2). complementary treatment diminishes relapse frequency but has no impact on survival.
authors.affiliation: Departments of Pediatric Hematology/Oncology of Hôpital, Armand Trousseau, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Pellegrino
authors.forename: M J
authors.initials: MJ
authors.lastname: Terrier-Lacombe
authors.forename: O
authors.initials: O
authors.lastname: Oberlin
authors.forename: T
authors.initials: T
authors.lastname: Leblanc
authors.forename: Y
authors.initials: Y
authors.lastname: Perel
authors.forename: Y
authors.initials: Y
authors.lastname: Bertrand
authors.forename: C
authors.initials: C
authors.lastname: Beard
authors.forename: C
authors.initials: C
authors.lastname: Edan
authors.forename: C
authors.initials: C
authors.lastname: Schmitt
authors.forename: D
authors.initials: D
authors.lastname: Plantaz
authors.forename: H
authors.initials: H
authors.lastname: Pacquement
authors.forename: J P
authors.initials: JP
authors.lastname: Vannier
authors.forename: C
authors.initials: C
authors.lastname: Lambilliote
authors.forename: G
authors.initials: G
authors.lastname: Couillault
authors.forename: A
authors.initials: A
authors.lastname: Babin-Boilletot
authors.forename: I
authors.initials: I
authors.lastname: Thuret
authors.forename: F
authors.initials: F
authors.lastname: Demeocq
authors.forename: G
authors.initials: G
authors.lastname: Leverger
authors.forename: G
authors.initials: G
authors.lastname: Delsol
authors.forename: J
authors.initials: J
authors.lastname: Landman-Parker
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D012074:Remission Induction; D016019:Survival Analysis; D016896:Treatment Outcome