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J Pediatr (Rio J). 2009 May-Jun;85(3):236-42.doi:10.2223/JPED.1891.

Number of involved anatomic areas as a risk predictor in pediatric Hodgkin's lymphoma: a retrospective study.

[Article in English, Portuguese]

Author information

1
Oncohematology Pediatric Center, Hospital Universitário Oswaldo Cruz, Recife, PE, Brazil.

Abstract

OBJECTIVES:

To determine if the number of involved anatomic areas can modify the standard risk groups in pediatric Hodgkin's lymphoma, identifying children who would benefit from a reduction in treatment intensity.

METHODS:

Retrospective study evaluating age, sex, histology, Ann-Arbor stage, presence of B symptoms, number of involved anatomic areas, risk grouping (favorable vs. unfavorable), and laboratory exams. All patients received doxorubicin-containing chemotherapy. Patients in complete remission for 5 years or longer were evaluated as for late effects.

RESULTS:

Sixty-nine patients (2-18 years) were included, 68% belonged to the unfavorable risk group. Overall survival and event-free survival were 94 and 87%, respectively. Late effects were screened in 46 cases. Advanced stage and > or = four involved anatomic areas had negative impact on event-free survival, while only the number of involved anatomic areas retained statistical significance when using Cox analysis (hazard ratio = 6.4, 95%CI = 1.08-38.33; p = 0.04). Risk groups were adjusted by number of involved anatomic areas (< four/> or = four involved anatomic areas), with a significant reallocation of patients (p = 0.008). Of the 30 patients with late effects, 21 were in the original unfavorable risk group and 14 (66.6%) could have been reallocated to the favorable risk group based on the number of involved anatomic areas.

CONCLUSIONS:

If re-stratification had been applied, a considerable number of children would have received less intensive treatment and, consequently, could have had lower chances of late effects. A prospective study could define if adjustment of risk group by number of involved anatomic areas would have any impact on survival rates.

PMID:
19492170
DOI:
doi:10.2223/JPED.1891
[Indexed for MEDLINE]
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