Pediatric blood & cancer · 2008
Developing anticancer chemotherapy services in a developing country: Hodgkin lymphoma experience.
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Chandra Jagdish, Naithani Rahul, Singh Varinder, Saxena Y K, Sharma Manoj, Pemde Harish
Аннотация
BACKGROUND AND OBJECTIVE: Reporting on how the cancer treatment facilities were developed at a medical college hospital in India and the profile and outcome of patients with Hodgkin lymphoma (HL) at this new center were the objectives of the study.
METHODS: Patients under 18 years with a diagnosis of HL were evaluated using abdominal ultrasonography, CT scan examination of chest, abdomen and pelvis and bone marrow examination. Most patients were treated with combination chemotherapy. Departments of Radiodiagnosis and Pathology were involved for evaluation. Radiotherapy when required was made available at a nearby hospital.
RESULTS: Thirty-five patients between 1.2 and 18 years (median age 7 years) were diagnosed as HL during the study period. Advanced disease (Stage IIb or more) was present in 83% cases. Mixed cellularity was the commonest histological subtype (50.5%). Primary therapy used was COPP in 29 (83%) cases. Of the 34 patients who received treatment 30 showed initial good response to therapy. One patient responded to ABVD after having progression on COPP. Of 31 responders, 4 relapsed. Twenty-seven patients (80%) are surviving free of disease for a median follow up of 4.5 years (range 1.5-18 years). Chemotherapy was well tolerated. Febrile neutropenia occurred in four cases.
CONCLUSIONS: Pediatric HL in India was characterized by advanced disease at presentation. Mixed-cellularity was the predominant histological subtype. An effective program was developed with initial attention to patients with HL.
METHODS: Patients under 18 years with a diagnosis of HL were evaluated using abdominal ultrasonography, CT scan examination of chest, abdomen and pelvis and bone marrow examination. Most patients were treated with combination chemotherapy. Departments of Radiodiagnosis and Pathology were involved for evaluation. Radiotherapy when required was made available at a nearby hospital.
RESULTS: Thirty-five patients between 1.2 and 18 years (median age 7 years) were diagnosed as HL during the study period. Advanced disease (Stage IIb or more) was present in 83% cases. Mixed cellularity was the commonest histological subtype (50.5%). Primary therapy used was COPP in 29 (83%) cases. Of the 34 patients who received treatment 30 showed initial good response to therapy. One patient responded to ABVD after having progression on COPP. Of 31 responders, 4 relapsed. Twenty-seven patients (80%) are surviving free of disease for a median follow up of 4.5 years (range 1.5-18 years). Chemotherapy was well tolerated. Febrile neutropenia occurred in four cases.
CONCLUSIONS: Pediatric HL in India was characterized by advanced disease at presentation. Mixed-cellularity was the predominant histological subtype. An effective program was developed with initial attention to patients with HL.