Clinical and Treatment Results of a Group of Children Diagnosed with Hodgkin Lymphoma in a Single Brazilian Institution

Hodgkin lymphoma (HL) is a heterogeneous disease. The treatment of HL relies on multimodality treatment.

There is no Brazilian pediatric protocol for HL. Most of the centers treat their patients with a combination of Chemotherapies (CH) base on ABDV ± OPPA ± radiotherapy (RDT), with good but not uniform results.

The aim of this study was to characterize clinical and treatment features of a group of children diagnosed with HL at Hospital Amaral Carvalho (HAC), Jau, SP, Brazil.

Between June 1996 and June 2013, 662 cases of HL were diagnosed at HAC. Among these 150 were children and adolescents. 54 patients were excluded from the analysis, 12% because of previous treatment, 5% lost of follow up and 19% due to institution filing problems.

We studied 96 children, (ages 2 to 18 years; median 12 years old). Nodular sclerosis (NS) was the more frequent histological subtype (41%), followed by mixed cellularity (MC) (12%). Early clinical stages (I/II) showed to be more common, 50%. B symptoms were more usually find in early clinical stages. Bulky disease was find in 14% of the patients, 17% of Stage I/II, 5% of Stage III/IV. The most common CH regime used was ABVD in first place (85%) and ABVD + other combination in second place (10%). 75% of the patients used radiotherapy also. Patients were treated with ABVD + other combination of CH in the first years, using only ABVD in the last years. 90% of the patients are alive. 5% lost follow up.

The heterogeneous treatment modalities seen in this study through the years make us think of a uniform and inter institutional protocol in order to benefit our patients.

Since the HAC is part of the new Latin American Consortium of Hemato-oncological Diseases (CLEHOP), created with the purpose of facilitating a cooperative effort to improve the rate of cure of children with cancer. We decided to join the The Central American Paediatric Haematology-Oncology Association (AHOPCA) and El Grupo Argentino de Tratamiento de la Leucemia Aguda (GATLA) study for Pediatric Hodgking's Lymphoma. But we will have a regional approach in order to improve the outcome and the quality of life of children with cancer within the frame of our cultural identities and similarities.