Clinical study of 83 cases of pediatric Hodgkin lymphoma

Objective To explore the clinical and pathological features of children with Hodgkin lymphoma (HL) and EBV status, and to summarize the efficacy and toxicity of risk-adapted combination of chemotherapy and low-dose involved-field radiation therapy (IFRT) according to the risk stratification. Methods 83 children with HL from January 2003 to April 2013 were enrolled, who received the detection of biopsy pathological morphology and immunohistochemistry. Pathology samples were reviewed and classified based on the World Health Organization (WHO) guidelines. Staging was based on clinical evaluation and was defined by the Ann Arbor staging system. According to the different risk factors, 83 patients were divided into three groups: low-risk group, intermediate-risk group and high-risk group. Results 83 HL children included 69 males and 14 females. 59 cases(71.1 %) were in stage Ⅲ-Ⅳ. Among 83 patients, one case suffered nodular lymphocyte predominant subtype, other 82 patients had classical HL including 64 cases (77.1 %) of mixed cellularity. Tumor invasion was extensive, 34 cases (41.0 %) had bulky lymph nodes, 26 cases (31.3 %) had more than 4 node regions involved, and 35 ceses (42.2 %) had B symptoms at presentation. 70 cases of pathology samples were detected by EBV encoded RNA (EBER) and/or latent membrane protein (LMP) staining, and 65 cases (92.9 %) were positive. There were 3 cases in low-risk group, 27 cases in intermediate-risk group and 53 cases in high-risk group. The overall survival (OS) rate was 97.5 % and the 5-year event free survival (EFS) rate was 92.8 % with a median follow-up of (72±32) months. Conclusions Pediatric HL occurs more frequent in male than in female, which is correlated with EBV and is consist mostly of mixed cellularity. Combined-modality therapy using risk-adapted chemotherapy with radiation is effective and well tolerated, with good prognosis, however, the adverse reaction needs to be observed further. Key words: Hodgkin disease; Children; Diagnosis; Therapies, investigational