Prognostic factors and treatment outcome in childhood Hodgkin disease.
BACKGROUND
The goals of this study included: (1) Identification of factors prognostic for event-free survival (EFS) and overall survival (OS), and (2) Definition of risk groups for risk adapted therapy in children with Hodgkin disease (HD).


METHODS
From 1991 to 2003, 69 children with newly diagnosed, untreated biopsy-proven stage I-IV HD were treated with chemotherapy (CT) and low-dose involved field radiotherapy (LD-IFRT). The relationship of pretreatment factors to EFS and OS was analyzed by univariate and multivariate analysis.


RESULTS
The 5-year EFS and OS for all patients were 90.77% and 96.22%, respectively with a median follow-up of 73 months (3-137 months). Male to female ratio was 3:1 and 21 children (32.3%) were less than 7 years of age. Mixed cellularity was the predominant histologic subtype (38.5%). Factors associated with inferior EFS by univariate analysis were extranodal disease, hemoglobin level <11 g/dl, number of involved lymph node regions and stage. By multivariate analysis only stage IV disease was significant.


CONCLUSIONS
Our study confirms that excellent results are achievable with combined modality therapy in childhood HD. In order to use risk-adapted therapy in children with HD, clinical prognostic factors should be validated with large, multicentered prospective clinical studies.
Oguz
Aynur
A
Department of Pediatrics, Professor of Pediatric Oncology, Chief of Division, Gazi University Faculty of Medicine, Beşevler/Ankara, Turkey.
Karadeniz
Ceyda
C
Okur
F Visal
FV
Citak
E Caglar
EC
Pinarli
F Guçlu
FG
Bora
Huseyin
H
Akyurek
Nalan
N
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006689:Hodgkin Disease / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D011379:Prognosis; D015996:Survival Rate; D016896:Treatment Outcome
D006454:Hemoglobins