Resection alone in 58 children with limited stage, lymphocyte-predominant Hodgkin lymphoma-experience from the European network group on pediatric Hodgkin lymphoma.
BACKGROUND
Lymphocyte-predominant Hodgkin lymphoma (LPHL) is a rare, CD20-positive, good prognostic lymphoma in children. Patients with early-stage LPHL who underwent successful surgical lymph node resection alone have been reported. To clarify the optimum treatment strategy in children, European study groups were asked to report their experience of surgery alone used in the treatment of pediatric LPHL.


METHODS
Data from 58 patients were collected by the French Society for Pediatric Cancers, the German-Austrian Pediatric Study Group/German Society of Pediatric Oncology and Hematology (Germany), and the Children's Cancer and Leukaemia Group (United Kingdom). In total, there were 50 boys and 8 girls, and the median age was 11 years (age range, 4-17 years). Fifty-four patients had stage IA disease, 2 patients had stage IIA disease, and 2 patients had stage IIIA disease.


RESULTS
With a median follow-up of 43 months (range, 2-202 months), the overall survival rate was 100%, and the progression-free survival (PFS) rate was 57%. Fifty-one of 58 patients achieved complete remission (CR) after surgery. In the CR group, the overall PFS rate was 67% (95% confidence interval, 51-82%). All seven patients who had residual disease after initial surgery developed recurrences (P = .003). Among 18 patients with stage IA LPHL who developed recurrent disease, 11 patients had local recurrences, and 7 patients recurred in stage IIA. One patient with stage IIIA disease presented with high-grade B-cell non-Hodgkin lymphoma at 10 years of follow-up.


CONCLUSIONS
When complete resection was achieved, a substantial proportion of patients with surgically treated, early-stage LPHL experienced long-term remission and actually may have been cured.
Mauz-Körholz
Christine
C
University Clinical and Health Center for Child and Youth Medicine, Halle-Wittenberg, Germany.
Gorde-Grosjean
Stephanie
S
Hasenclever
Dirk
D
Shankar
Ananth
A
Dörffel
Wolfgang
W
Wallace
W Hamish
WH
Schellong
Günther
G
Robert
Alain
A
Körholz
Dieter
D
Oberlin
Odile
O
Hall
Georgina W
GW
Landman-Parker
Judith
J
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005060:Europe; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D015996:Survival Rate; D016896:Treatment Outcome