Klin Padiatr 2014; 226 - P_12
DOI: 10.1055/s-0034-1371114

Influence of Age on Treatment Results in Children and Adolescence with Hodgkin's Lymphoma Polish Experience

W Balwierz 1, T Klekawka 1, A Moryl-Bujakowska 1, M Matysiak 2, I Malinowska 2, A Chybicka 3, R Chaber 3, T Szczepanski 4, A Janik-Moszant 4, J Wachowiak 5, A Wziatek 5, J Kowalczyk 6, M Mitura-Lesiuk 6, E Adamkiewicz-Drozynska 7, T Stachowicz-Stencel 7, M Wysocki 8, A Koltan 8, M Krawczuk-Rybak 9, K Muszynska-Roslan 9, W Mlynarski 10, M Stolarska 10, G Sobol 11, M Wieczorek 12, T Piatek 12, G Karolczyk 13, A Dadela-Urbanek 13, T Urasinski 14, E Kamienska 14, K Dzikowska 1
  • 1Polish-American Institute of Pediatrics, Jagiellonian University Medical College, Department of Pediatric Oncology and Hematology, Krakow, Poland
  • 2Warsaw Medical University, Department of Pediatrics, Hematology and Oncology, Warszawa, Poland
  • 3Wroclaw Medical University, Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw, Poland
  • 4Medical University of Silesia, Department of Pediatric Hematology and Oncology, Zabrze, Poland
  • 5University of Medical Sciences, Department of Pediatric Oncology, Hematology and Transplantology, Poznan, Poland
  • 6Medical University, Department of Children's Hematology and Oncology, Lublin, Poland
  • 7Department of Pediatrics, Hematology and Oncology, Medical University, Gdansk, Poland
  • 8Nicolaus Copernicus University Collegium Medicum, Department of Pediatric Oncology and Hematology, Bydgoszcz, Poland
  • 9Medical University, Department of Children's Oncology and Hematology, Bialystok, Poland
  • 10Medical University, Department of Pediatrics, Oncology, Hematology and Diabetology, Lodz, Poland
  • 11Department of Pediatrics, Oncology, Hematology and Diabetology, Oncology, Hematology and Chemotherapy Unit, Pediatric Department, Katowice, Poland
  • 12Chorzow Center of Pediatrics and Oncology, Hematology and Oncology Unit, Chorzow, Poland
  • 13Children's Hospital, Hematology and Oncology Unit, Kielce, Poland
  • 14Pomeranian Medical University, First Department of Pediatrics, Szczecin, Poland

Question: Does age of children and adolescence influence on Hodgkin's lymphoma (HL) treatment results?

Methods: From 1997 to 2008, in 14 Polish Pediatric Leukemia Lymphoma Study Group centers, 803 patients (age 2 – 18 years) were treated for HL. In all children MVPP and B-DOPA chemotherapy with or without radiotherapy was introduced.

Results: The first remission was achieved in 787 patients (98%). Relapses occurred in 34 patients (4.2%). The 5-year probability of overall survival, relapse-free survival (RFS) and event-free survival (EFS) was 96%, 95.5% and 92%, respectively. The logistic regression analysis of age did not reveal the border value for increasing the probability of relapse or event. Despite of that we have done comparison of treatment results in age groups: below and over 10 years of age, as this age proved to be the borderline age for relapse. The probability of 5-year EFS for children below and above 10 years of age was 95% and 92%, respectively, and the probability of 5-year RFS was 97% and 95%, respectively. The differences were not statistically significant, but among children over 10 years of age some features of the disease occurred more frequently: presence of mediastinal tumor, IIIB and IV stage of the disease, NS type, presence B symptoms, ESR over 50 mm/1h, greater tumor burden and higher number of involved lymphatic regions. Among the patients over 10 year of age, the presence of mediastinal tumor, more advanced disease and ESR over 50 mm/1h significantly influenced the occurrence of relapses (P = 0.016, 0.05 and 0.05, respectively).

Conclusions: The aim of the further treatment modifications ought to comprise the need of better treatment outcome in HL in patients over 10 years of age in which unfavorable prognostic factors are identified.