title: The prognostic value of biological markers in paediatric Hodgkin lymphoma.
abstract: BACKGROUND
  Many biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children.
  
  
  METHODS
  By using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens.
  
  
  RESULTS
  On multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography.
  
  
  CONCLUSIONS
  Using the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes.
authors.affiliation: Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy. Electronic address: piero.farruggia@arnascivico.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Farruggia
authors.affiliation: Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Puccio
authors.affiliation: Clinica Pediatrica, Universita' Milano-Bicocca A.O. San Gerardo-Fondazione MBBM, Monza, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sala
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Todesco
authors.affiliation: Dipartimento di Oncologia Pediatrica A.O. Santobono-Pausilipon, Napoli, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Buffardi
authors.affiliation: Dipartimento di Ematologia e Oncologia Pediatrica, Istituto G. Gaslini, Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.affiliation: Servizio di Oncologia Pediatrica, Dipartimento di Pediatria II Ateneo di Napoli, Napoli, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bottigliero
authors.affiliation: S.C. Oncoematologia Pediatria e Centro Trapianti, Ospedale Infantile Regina Margherita, Torino, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Oncoematologia Pediatrica, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Zecca
authors.affiliation: Oncoematologia Pediatrica, IRCCS Ospedale Bambino Gesù, Roma, University of Pavia, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Locatelli
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, "Lalla Seragnoli" Clinica Pediatrica Policlinico Sant'Orsola Malpighi, Bologna, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pession
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.affiliation: Oncologia Clinica Pediatrica e Trapianto Midollo Osseo, Azienda Ospedaliera-Università, Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Favre
authors.affiliation: Oncologia Pediatrica, Clinica Pediatrica, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Amico
authors.affiliation: Sezione Oncoematologia Pediatrica, Dipartimento di Pediatria, Ospedali Riuniti di Bergamo, Bergamo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Provenzi
authors.affiliation: Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Trizzino
authors.affiliation: U.O. Emato-Oncologia Pediatrica, Università degli Studi di Trieste Osp.le Infantile Burlo Garofolo, Trieste, Italy.
authors.forename: Giulio Andrea
authors.initials: GA
authors.lastname: Zanazzo
authors.affiliation: U.O. Oncoematologia Pediatrica, Ospedale Civile Spirito Santo, Pescara, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Sau
authors.affiliation: Dipartimento Biomedicina Eta' Evolutiva, U.O. Pediatrica I Policlinico, Bari, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Santoro
authors.affiliation: Oncoematologia Pediatrica e Patologia della coagulazione, Ospedale Regionale per le Microcitemie, Cagliari, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Murgia
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, A.O.U Meyer, Firenze, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Casini
authors.affiliation: S.S. Radioterapia Pediatrica e Area Giovani, IRCCS, Centro di Riferimento Oncologico Aviano, Pordenone, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mascarin
authors.affiliation: Oncoematologia Pediatrica, Azienda Ospedaliera Universitaria, Ospedale Sant'Anna, Ferrara, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Burnelli
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood*; D001792:Blood Platelets; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D018450:Disease Progression; D018572:Disease-Free Survival; D004804:Eosinophils; D005260:Female; D005293:Ferritins / Q000097:blood*; D006689:Hodgkin Disease / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy; D053208:Kaplan-Meier Estimate; D007958:Leukocyte Count; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010976:Platelet Count; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D005293:Ferritins
keywords: Hodgkin lymphoma; Paediatric; Prognostic factor