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DOI: 10.1055/s-0034-1371142
BEACOPP Protocol in 60 Children with Hodgkin's Lymphoma (HL): Multicenter Experience in 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.