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. 2022 Mar 13;14(6):1471.
doi: 10.3390/cancers14061471.

Outcome of Children and Adolescents with Recurrent Classical Hodgkin Lymphoma: The Italian Experience

Alberto Garaventa  1 , Stefano Parodi  2 , Giulia Guerrini  3 , Piero Farruggia  4 , Alessandra Sala  5 , Marta Pillon  6 , Salvatore Buffardi  7 , Francesca Rossi  8 , Maurizio Bianchi  9 , Marco Zecca  10 , Luciana Vinti  11 , Elena Facchini  12 , Tommaso Casini  13 , Sayla Bernasconi  14 , Loredana Amoroso  1 , Salvatore D'Amico  15 , Massimo Provenzi  16 , Raffaela De Santis  17 , Antonella Sau  18 , Paola Muggeo  19 , Rosa Maria Mura  20 , Riccardo Haupt  2 , Maurizio Mascarin  21 , Roberta Burnelli  22
Affiliations

Outcome of Children and Adolescents with Recurrent Classical Hodgkin Lymphoma: The Italian Experience

Alberto Garaventa et al. Cancers (Basel). .

Abstract

The objective of this study was to identify prognostic factors for children and adolescents with relapsed or progressive classical Hodgkin’s lymphoma (cHL) to design salvage therapy tailored to them. We analyzed a homogeneous pediatric population, diagnosed with progressive/relapsed cHL previously enrolled in two subsequent protocols of the Italian Association of Pediatric Hematology and Oncology in the period 1996−2016. There were 272 eligible patients, 17.5% of treated patients with cHL. Overall survival (OS) and event-free survival (EFS) after a 10-year follow-up were 65.3% and 53.3%, respectively. Patients with progressive disease (PD), advanced stage at recurrence, and ≥5 involved sites showed a significantly worse OS. PD, advanced stage, and extra-nodal involvement at recurrence were significantly associated with a poorer EFS. Multivariable analysis identified three categories for OS based on the type of recurrence and number of localizations: PD and ≥5 sites: OS 34%; PD and <5 sites: OS 56.5%; relapses: OS 73.6%. Four categories were obtained for EFS based on the type of recurrence and stage: PD and stage 3−4: EFS 25.5%; PD and stage 1−2: EFS 43%; relapse and stage 3−4: EFS 55.4%; relapse and stage 1−2: EFS 72.1%. Patients with PD, in advanced stage, or with ≥5 involved sites had a very poor survival and they should be considered refractory to first- and second-line standard chemotherapy. Probably, they should be considered for more innovative approaches since the first progression. Conversely, patients who relapsed later with localized disease had a better prognosis, and they could be considered for a conservative approach.

Keywords: Hodgkin’s lymphoma; adolescents; children; prognostic factors; relapse; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient selection for statistical analyses.
Figure 2
Figure 2
Overall and event-free survival after disease recurrence in 272 cHL patients.
Figure 3
Figure 3
Survival after relapse or progression of 272 classical Hodgkin’s lymphoma patients by characteristics at relapse identified by multivariable Cox regression model. Panel (A): overall survival. Panel (B): event-free survival.
See this image and copyright information in PMC

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