title: Outcome of children and adolescents with recurrent/refractory classical Hodgkin lymphoma, a study from the Société Française de Lutte contre le Cancer des Enfants et des Adolescents (SFCE).
abstract: There is little data available regarding children and adolescents with Hodgkin lymphoma (HL) who relapse after combined-modality treatment, even though they have a substantial chance of cure. The purpose of this national retrospective study was to evaluate the outcome of patients with recurrent/refractory HL and determine adverse prognostic factors. From 1990 to 2006, 70 patients (median age 13·9 years) with refractory (n = 31) or first relapse (n = 39) HL were identified. Median time from end of treatment to relapse was 6 months (3-56). Relapses occurred in irradiated areas in 43/70 patients. Salvage therapy consisted of chemotherapy and 50 patients received high-dose chemotherapy with autologous stem cell transplantation. Radiotherapy was performed in 29 cases, tandem autologous transplantation in five and allograft in three. With a median follow-up of 40 months (2-140), significant prognostic factors were time to progression/relapse and response to therapy before autograft. Event-free survival and overall survival in patients with refractory disease, early relapse and late relapse were 35 ± 9%, 67 ± 11%, 76 ± 10% and 48 ± 11%, 89 ± 7% and 80 ± 10%, respectively. As progression <3 months was a major adverse prognostic factor, novel therapeutic approaches are needed for this group of patients. By contrast, patients have substantial chance of long term second remission in case of relapse >3 months.
authors: Pediatric, CHU Reims, Reims, France.
authors: Stéphanie
authors: S
authors: Gorde-Grosjean
authors: Odile
authors: O
authors: Oberlin
authors: Thierry
authors: T
authors: Leblanc
authors: Hélène
authors: H
authors: Pacquement
authors: Jean
authors: J
authors: Donadieu
authors: Anne
authors: A
authors: Lambilliotte
authors: Mathias
authors: M
authors: Schell
authors: Florence
authors: F
authors: Dommange
authors: Martine
authors: M
authors: Munzer
authors: Catherine
authors: C
authors: Paillard
authors: Claudine
authors: C
authors: Schmitt
authors: Patrick
authors: P
authors: Lutz
authors: Christine
authors: C
authors: Edan
authors: Sophie
authors: S
authors: Ansoborlo
authors: Jean-Louis
authors: JL
authors: Stephan
authors: Gérard
authors: G
authors: Michel
authors: Caroline
authors: C
authors: Thomas
authors: Yves
authors: Y
authors: Perel
authors: Alain
authors: A
authors: Robert
authors: Judith
authors: J
authors: Landman-Parker
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000401:mortality; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005602:France / Q000453:epidemiology; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000401:mortality; D033581:Stem Cell Transplantation / Q000401:mortality; D016896:Treatment Outcome