Hodgkin's Disease

Published Date: 19th July 2016

Publication Authors: Aabideen K

​

Purpose:  Published literature from India on HD in children is scant. This comprehensive review of published and grey literature was conducted to understand the current management and outcome of childhood HD in India.

Methods:  A search of MEDLINE and EMBASE was carried out. The search was limited to studies published from 2000 onwards. Abstracts presented at SIOP annual congresses (2000- 2011) were also hand-searched.

Results:  Of the 103 studies identified, 16 single-centre studies (4 papers and 12 abstracts) from 14 centres met the inclusion criteria. There were a total of 958 children with HD (11- 148 children/study). The median age at presentation was 7-9 years in majority of the studies and the median male to female ratio was 4.4:1. Majority (median 64%, range 33-92%) had stage >=IIB/III HD at presentation. Mixed cellularity was the most common histology (median 50%, range 27-86%). Positive Emission Tomography (PET) was not used in any centre. Treatment consisted of chemotherapy +/- radiotherapy but there was considerable variation among centres. Several chemotherapy regimens were used, most commonly ABVD, COPP or ABVD/COPP, often without risk stratification. Radiotherapy use varied from no use, to use in selected patients (e.g. bulky disease or non-responders), to use in all patients. There was evidence from a single RCTof the benefit of involved field RT to patients with B symptoms and bulky disease (1). Median OS was 92% (range 43-100%) and EFS 84% (Range 63-100%). Reported range of relapse, mortality and abandonment rates were 4.5-33, 0.7-20.8 and 3.7-21% respectively. Data on long term side effects and locally relevant prognostic factors was

very limited.

Conclusion:  Survival outcomes of HD in children in India are encouraging. We recommend co-ordinated multicentre approach in treating and analysing the experiences to address several questions including risk stratification and late effects to improve the outcome further.

Aabideen, K; Kulkarni, KP; Arora, RS. (2012).  Current outcomes of hodgkin's disease (HD) among children in India: A systematic analysis . Pediatric Blood and Cancer. 59 (6), 1042

« Back