Pediatric Hodgkin lymphoma: Characteristics, stratification,treatment and survival at a single institute in Lima-Perú.

Introduction Lymphomas represent fourth most commom cancer in peruvian children (10% of all cases).Currently, different cooperative groups are reducing intensity of chemotherapy and radiotherapy with intension to improve survival and reduce sequelae. Limited data such as information on epidemiology and survival are available in peruvian pediatric population .This study aimed to describe clinical, histological characteristics, risk group distribution and survival in pediatric Hodgkin lymphoma(HL) patients

Methods Children (≤14 years old) diagnosed with histologically proven HL from 2009 to 2015 were retrospectively analyzed. . The Kaplan-Meier survival curves were used for survival analysis.

Results 117 patients were enrolled; predominantly male 3:1, mean age of 7.3 years, range 3 to 14 years and 72 % came from outside Lima. Disease time has a mean of 8 months, B symptoms were present in 45 %, 51.6% has bulky mass, primary site was neck in 47%, 52.8% of the patients were at high risk group. The histopathological diagnosis was mixed celular type in 52.9% and nodular sclerosis in 19.5% of the patients,64.9% express latent membrane protein 1 (LMP1) by inmunohistochemestry. We used ABVD chemotherapy to treat low/intermedate risk and ABVD/COPD for high risk group, 68% has good early response, 80% of slow early responders receive radiotherapy at mean dose 2600 cGy, 18.8% of patients left therapy, 11.7% relapse. With a median follow-up of 24 months, the 5-year overall and event-free survival rates were 94.2% and 92.7% respectively (abandonment is not included). Sex, treatment risk groups, presence of B symptoms, bulky mass and histology type had no significant effect on overall survival.

Conclusion Advanced disease, bulky mass, B symptoms, EBV expression and mixed celular histology are main characteristics in peruvian HL. We must to improve education and follow up to reduce high abandonment rates.

Conflict of Interest:

no conflicts of interest

• References

• 1 Hsu SC, Metzger ML, Hudson MM. , et al. Comparison of treatment outcomes of childhood Hodgkin lymphoma in two US centers and a center in Recife, Brazil. Pediatr Blood Cancer. 2007; 49: 139-144 .
• 2 Oguz A, Karadeniz C, Okur FV. , et al. Prognostic factors and treatment outcome in childhood Hodgkin disease. Pediatr Blood Cancer 2005; 45: 670-675 .
• 3 Gulley ML, Eagan PA, Quintanilla-Martinez L. , et al. Epstein-Barr virus DNA is abundant and monoclonal in the Reed-Sternberg cells of Hodgkin’s disease: Association with mixed cellularity subtype and Hispanic American ethnicity. Blood. 1994; 83: 1595-1602 .
• 4 Shamoon RP, Ali MD, Shabila NP. Overview and outcome of Hodgkin’s Lymphoma: experience of a single developing country’s oncology centre. PLoS One. 2018; 13 (04) : e0195629 .
• 5 Dinand V, Arya LS. Epidemiology of childhood Hodgkins disease: is it different in developing countries? Indian Pediatr. 2006; 43 (02) : 141-147 .