Klin Padiatr 2014; 226 - P_27
DOI: 10.1055/s-0034-1371142

BEACOPP Protocol in 60 Children with Hodgkin's Lymphoma (HL): Multicenter Experience in Venezuela

G Correles de Acquatella 1, R Garcia Guevara 1, R Montilva 2, B Urdaneta de Ramos 2, N Rojas 3, A Paez 4, D Falcon 5, O Carrasquel 6, M Rivero 7, S Pachano 7, L Cardenas 8, M Mejias 9, C Sarache 9, E Montero 10, MA Torres 11, M Marval 12, C Mendoza 13, N Barrios 14
  • 1Fundacion BADAN, Asesoria Cientifica, Caracas, Venezuela
  • 2Hospital de Especialidades Pediatricas, Hematologia, Maracaibo, Venezuela
  • 3Instituto Oncologico Luis Razetti, Oncologia, Caracas, Venezuela
  • 4Hospital Central de San Cristobal, Oncologia, San Cristobal, Venezuela
  • 5Hospital Dr. Domingo Luciani, Hematologia Pediatrica, Caracas, Venezuela
  • 6Centro Clinico Familia, Hematologia, Puerto Ordaz, Venezuela
  • 7Hospital de Niños J.M de Rios, Hematologia Pediatrica, Caracas, Venezuela
  • 8Hospital Dr. Miguel Perez Carreño, Hematologia Pediatrica, Caracas, Venezuela
  • 9Hospital Dr. Pedro Emilio Carrillo, Hematologia Pediatrica, Valera, Venezuela
  • 10Hospital Universitario, Hematologia Pediatrica, Caracas, Venezuela
  • 11Clinica Santa Sofia, Hemato-Oncologia, Caracas, Venezuela
  • 12Hospital Dr. Antonio Patricio de Alcala, Hematologia Pediatrica, Cumana, Venezuela
  • 13Centro Integral de Hematologia y Oncologia Médica, Hemato-Oncologia, Mérida, Venezuela
  • 14Hospital Dr. Placido Daniel Rodriguez Rivero, Hematologia Pediatrica, San Felipe, Venezuela

Introduction: Between 2006 – 2009, 52 children receiving BEACOP scheme (due to unavailable Procarbazine in Venezuela) had unsatisfactory results. Since Procarbazine was available, 60 patients (pts) treated with BEACOPP from 2008 to 2013 are now presented.

Patients and methods: From July 2008 to May 2013, 60 pts < 19 years, newly diagnosed HL were included. There were 36 males (60%), mean age 12.8 ± 4 SD yrs. Prognostics factors (PF) were: clinical stage, B symptoms, bulky disease ≥5 cm, ≥4 nodal regions, mediastinal mass ≥30% t.d, sedimentation rate ≥50 mm 1st h. We had 2 groups: Favorable Group (FG): ≤2 PF, Unfavorable Group (UG): ≥3 PF. All pts had CAT-Scan before treatment and CT-PET 1 month after 4 cycles (cs) and at end of treatment. FG received 4cs BEACOPP escalated descendent (ed), UG had 4cs BEACOPP ed and consolidation with 2cs BEACOPP standard. They received GCSF x 7 d after each cs and involved field radiotherapy (IFRt) if residual disease was present at end of chemotherapy.

Results: Among 60pts, 13 were FG (22%), all had CR, 1 was lost to follow up. 47 were UG (78%), 38 (81%) CR, 9 (19%) had PR. Among them: 6 pts (67%) attained CR after IFRt and 3 pts failure and had salvage treatment. Event free suvirval (EFS) and Overall suvirval (OS) in FG: were 100% with median follow up 36 months. In UG: EFS 72% and OS 85% with median follow up 36 months. Events: Relapses 7%, mortality 5%, toxicity: febrile neutropenia 12%, infection 3%, gastrointestinal (mucosity) 2%, second tumor 2%, 1 pt UG developed Ewing's Sarcoma (ES) after 4yrs in CR of HL and she is alive after ES treatment.

Conclusions: As this new series included the use of: Procarbazine, CT-PET, and increased expertise, we attained better results.