Treatment Outcome and Prognostic Factors in Children and Adolescents with Relapsed and Refractory Classic Hodgkin Lymphoma... | ||
| SECI Oncology Journal | ||
| Volume 12, Issue 2, April 2024, Pages 112-121 | ||
| Abstract | ||
| Background: Children with Hodgkin lymphoma (HL) achieve high cure rate around 80%, while 20% will ultimately relapse. Identifying reliable risk factors to guide treatment plans at relapse is essential. The purpose of this study is to evaluate the outcome and prognostic factors that affect the outcome of pediatric patients with relapsed and refractory classic HL. Methods: A retrospective descriptive cohort study included all patients with relapsed and refractory classic HL at the Children's Cancer Hospital of Egypt (CCHE-57357) from July 2007 to December 2018. Results: One hundred twenty-nine patients were eligible for the study. Male to female ratio was 1.9:1. The median age at relapse was 10.5 years. Time to relapse, stage at relapse, and response to salvage chemotherapy, all had a significant impact on survival outcomes. Overall survival (OS) and event-free survival (EFS) were 38.3% and 25% for those with refractory disease, while for early relapse were 68.0% and 49.6%, and 91.2% and 58.3% for those with late relapse, with p values of 0.001 and 0.001, respectively. At relapse, stage I patients had 100% OS and EFS and declined to 80% and 59.3%, respectively for stage II and 81.7% and 42.3% for stage III. The lowest OS and ES was observed in stage IV disease standing for 68% and 34.5%, respectively, with statistically significant differences for both OS and EFS (P values of 0.001). Patients who achieved negative positron emission tomography-computed tomography (PET-CT) after 2 cycles had OS and EFS of 91% and 70.1%, compared to 70% and 29.3% for those with positive PET-CT (p = 0.001 for both). Multivariate analysis identified two predictors of lower EFS: time to relapse and PET-CT response after salvage therapy. The 5-year OS and EFS rates for the cohort were 76% and 48.1%, respectively Conclusions: The prognostic factors that have the most significant impact on the survival outcome of pediatric patients with relapsed and refractory classic HL are the time to relapse, and PET CT response after 2 cycles. | ||
| Keywords | ||
| Hodgkin lymphoma; relapsed; refractory; outcome; prognostic factors | ||
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