Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 1;16(1):e2024053.
doi: 10.4084/MJHID.2024.053. eCollection 2024.

Hodgkin Lymphoma in Children: A 16-year Experience at the Children's Welfare Teaching Hospital of Baghdad, Iraq

Anna Maria Testi  1 , Mazin Faisal Al-Jadiry  2 , Maria Luisa Moleti  1 , Stefania Uccini  3 , Amir Fadhil Al-Darraij  4 , Raghad Majid Al-Saeed  4 , Hasanein Habeeb Ghali  2 , Ahmed Hatem Sabhan  4 , Samaher Abdulrazzaq Fadhil  4 , Safaa Abdulelah Al-Badri  5 , Adil Rabeea Alsaadawi  6 , Ameer Dh Hameedi  7 , Manhal Hashim Shanshal  4 , Yasir Saadoon Al-Agele  4 , Fatimah Abdul Ridha Al-Saffar  4 , Nihal Khalid Yaseen  4 , Alfonso Piciocchi  8 , Giovanni Marsili  8 , Salma Abbas Al-Hadad  2
Affiliations

Hodgkin Lymphoma in Children: A 16-year Experience at the Children's Welfare Teaching Hospital of Baghdad, Iraq

Anna Maria Testi et al. Mediterr J Hematol Infect Dis. .

Abstract

Background: Childhood Hodgkin lymphoma (HL) is an eminently curable disease. Good outcomes can be achieved even in resource-limited settings, and the focus is increasingly on limiting long-term toxicity. Contemporary treatment incorporates a risk-stratified, response-adapted approach using multiagent chemotherapy with/without low-dose radiotherapy. Many developing countries continue to use ABVD-based regimens due to limited acute toxicity, cost, and ease of delivery.

Objective: We herein report the outcomes of childhood HL diagnosed and treated in an Iraqi single centre over 16 years.

Methods: Children ≤14 years old with biopsy-proven HL were enrolled. Most patients received ABVD chemotherapy or COPP/ABV when Dacarbazine was unavailable. Radiotherapy was not available.

Results: Three hundred-three children were consecutively newly diagnosed with HL; 284 were considered eligible for the retrospective analysis (treatment refusals 9; deaths before therapy 5; initially diagnosed of non-Hodgkin lymphoma 5). ABVD scheme was administered to 184 children (65%), COPP/ABV to 83 (29%), and other schemes to the remaining 17 patients. Complete response (CR) was achieved in 277 (98%); 4 (1.4%) showed disease progression, and 1 had stable disease. Four patients in CR abandoned therapy and were in CR at the time of analysis, 2 died from infection. Relapse occurred in 42 patients (15%). The 15-year OS and EFS are 89.7% and 70.3%, respectively.

Conclusion: In this single Centre, over 16 years, almost 90% of children suffering from HL survive, despite the numerous limitations in diagnostic procedures, shortage of chemotherapy, no radiotherapy facilities, absence of effective second-line treatments, and finally, therapy abandonment for social and financial reasons.

Keywords: Children; Developing Countries; Hodgkin Lymphoma; chemotherapy.

PubMed Disclaimer

Conflict of interest statement

Competing interests: The authors declare no conflict of Interest.

Figures

Figure 1
Figure 1
A) Overall survival and B) event-free Survival.
Figure 2
Figure 2
A) Overall survival and B) event-free survival by risk group: early and advanced.
Figure 3
Figure 3
A) Overall survival and B) event-free survival by EBV: positive and negative.
See this image and copyright information in PMC

References

    1. Flerlage JE, Hiniker SM, Armenian S, Benya EC, Bobbey AJ, Chang V, Cooper S, Coulter DW, Cuglievan B, Hoppe BS, Isenalumbe L, Kelly K, Kersun L, Lamble AJ, Larrier NA, Magee J, Oduro K, Pacheco M, Price AP, Roberts KB, Smith CM, Sohani AR, Trovillion EM, Walling E, Xavier AC, Burns JL, Campbell M. PaediatricHodgkin Lymphoma, Version 3.2021. J Natl Compr Canc Netw. 2021;19(6):733–754. doi: 10.6004/jnccn.2021.0027. - DOI - PubMed
    1. Childhood Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version. PDQ Cancer Information Summaries [Internet] Bethesda (MD): National Cancer Institute (US); 2002. 2023. Sep 14, PDQ PaediatricTreatment Editorial Board.
    1. New guidelines for paediatricHodgkin lymphoma. The Lancet Haematol. 2020;7(12):e851. doi: 10.1016/S2352-3026(20)30371-9. - DOI - PubMed
    1. Lo AC, Dieckmann K, Pelz T, Gallop-Evans E, Engenhart-Cabillic R, Vordermark D, Kelly KM, Schwartz CL, Constine LS, Roberts K, Hodgson D. Paediatricclassical Hodgkin lymphoma. Pediatr Blood Cancer. 2021;68(Suppl 2):e28562. doi: 10.1002/pbc.28562. - DOI - PubMed
    1. Jain S, Kapoor G, Bajpai R. ABVD-based Therapy for Hogkin Lymphoma in Children and Adolescents: lessons Learnt in a Tertiary Care Oncology Center in a Developing Country. Pediatr Blood Cancer. 2016;63:1024–1030. doi: 10.1002/pbc.25935. - DOI - PubMed