Outcome of Hodgkin's Disease in Children with Chemotherapy alone in a Resource Limited Country

2017 ◽  
Vol 1 (01) ◽  
pp. 5-8
Author(s):  
ATM Atikur Rahman ◽  
Farida Yasmin ◽  
Momena Begum ◽  
Tanvir Ahammed ◽  
Afiqul Islam
Keyword(s):  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Complete Response ◽  
Hodgkin's Lymphoma ◽  
Present Moment ◽  
Outpatient Basis ◽  
Open Label ◽  
Quasi Experimental

Background: Treatment of Hodgkin's lymphoma involves both chemotherapy and radiotherapy. But radiotherapy in children is associated with risk of development of long-term complications like the development of second malignancy. Novel therapeutic strategies with combination chemotherapy without radiotherapy are being used to reduce such complications while maintaining the optimum response. Objective: To investigate the outcome of treatment of Hodgkin's Lymphoma with combination chemotherapy ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) alone.  Patients and methods: A quasi-experimental open label clinical study was done on 48 children with Hodgkin's lymphoma in the Paediatric Haemato-Oncology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) with eight cycle ABVD regime on an outpatient basis over a period of 8 months to see the outcome of treatment. Results: The mean age of the patients was 10.3 years (range 3-16). There were 42 males and 6 females. Mixed cellularity cHL was the commonest histological subtype observed 20/48 (42%) patients. Forty-two (88%) patients achieved complete response (CR), 5 (10%) had partial response (PR) and one patient did not respond at all. Fifteen patients (31%) are known to be dead and the rest are alive and tumour free. Median EFS and OS were not achieved. The EFS and OS at 5 years were 63% and 67% respectively. Conclusion: ABVD combination should be regarded at the present moment as the simplest and most effective drug therapy for treating childhood Hodgkin's disease.

scholarly journals Hodgkin's disease and non-hodgkin's lymphoma containing reed-sternberg-like giant cells in Taiwan: A clinicopathologic analysis of 50 cases

Cancer ◽  
2010 ◽  
Vol 69 (5) ◽  
pp. 1254-1258 ◽  
Author(s):  
Ruey-Long Hong ◽  
Ih-Jen Su ◽  
Yao-Chang Chen ◽  
Hong-Chong Hsieh ◽  
Chiu-Hwa Wang ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Giant Cells ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

High-dose carmustine, etoposide, and cisplatin and autologous bone marrow transplantation for relapsed and refractory lymphoma.

1992 ◽  
Vol 10 (11) ◽  
pp. 1682-1689 ◽  
Author(s):  
H M Lazarus ◽  
P Crilley ◽  
N Ciobanu ◽  
R J Creger ◽  
R M Fox ◽  
...  
Keyword(s):  
Hodgkin's Disease ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Autologous Bone Marrow Transplantation ◽  
Autologous Bone Marrow ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Autologous Bone ◽  
Disease Free

PURPOSE We determined the toxicity and efficacy of a new preparative autologous bone marrow transplantation (ABMT) regimen in patients with relapsed or refractory non-Hodgkin's lymphoma or Hodgkin's disease. PATIENTS AND METHODS Forty-four non-Hodgkin's lymphoma and 35 Hodgkin's disease patients 16 to 63 years of age were given intravenous carmustine (BCNU) 600 to 1,050 mg/m2, etoposide 2,400 to 3,000 mg/m2, and cisplatin 200 mg/m2 (BEP) and ABMT. Fifty-nine patients also received 15 to 20 Gy local radiation (involved-field radiotherapy [RI]) to active or previously bulky (> 5 cm) disease sites. RESULTS Nonhematologic toxicities included nausea, vomiting, high-tone hearing loss, stomatitis, esophagitis, diarrhea, and hepatic and pulmonary toxicity. Two patients died within 40 days of marrow infusion as a result of sepsis and one patient died 7 months after transplant as a result of pulmonary fibrosis. Complete remissions (CRs) were noted in 72% (n = 57) of patients (n = 33 non-Hodgkin's lymphoma; n = 24 Hodgkin's disease). Forty patients (51%) remained alive and disease-free (n = 24 non-Hodgkin's lymphoma; n = 16 Hodgkin's disease) at a median of 17 (range, 8 to 57) months after marrow reinfusion. CONCLUSIONS This regimen seems to be effective for relapsed lymphoma patients whose disease continues to exhibit chemotherapy sensitivity (16 of 24 [67%] disease-free). Furthermore, this regimen seems to be effective in patients who have never attained a CR (seven of 19 [37%] disease-free).

scholarly journals Non-Hodgkin's lymphoma after prolonged remission of Hodgkin's disease in an HTV-infected patient

1991 ◽  
Vol 2 (8) ◽  
pp. 585-587 ◽  
Author(s):  
C. Montalban ◽  
C. Bellas ◽  
J.L. Rodriguez-Garcia ◽  
M. Aguado ◽  
R. Fernandez-Muñoz
Keyword(s):  
Hodgkin's Disease ◽  
Infected Patient ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Bone marrow involvement in Hodgkin's disease: an analysis of 135 consecutive cases. German Hodgkin's Lymphoma Study Group.

1995 ◽  
Vol 13 (2) ◽  
pp. 403-409 ◽  
Author(s):  
R Munker ◽  
D Hasenclever ◽  
O Brosteanu ◽  
E Hiller ◽  
V Diehl
Keyword(s):  
Bone Marrow ◽  
Hodgkin's Disease ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin’S Disease ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Hodgkin's Lymphoma ◽  
Study Group ◽  
Prognostic Relevance ◽  
Lymphoma Study Group

PURPOSE To describe the incidence of primary bone marrow involvement (BMI) in Hodgkin's disease (HD) and its correlation with clinical and laboratory features present at diagnosis, and to evaluate the prognostic relevance of BMI. PATIENTS AND METHODS Between 1983 and 1991, 2,307 patients with HD were treated according to two trial generations (HD1-3 and HD4-6) of the German Hodgkin's Lymphoma Study Group (GHSG). RESULTS One hundred thirty-five cases of primary BMI were observed. The incidence of BMI was 4.8% in the HD4-6 study generation, which included all stages. Among stage IV patients, 32% had BMI. Among those with BMI, other organs were also involved in 33%. Among all patients, the presence of BMI was significantly associated with B symptoms, lymph nodes on both sides of the diaphragm, mixed cellularity histologic subtype, leukocytopenia, anemia, thrombocytopenia, lactate dehydrogenase (LDH) level more than 400 U/L, and erythrocyte sedimentation rate (ESR) more than 40 mm/h. BMI was negatively correlated with a large mediastinal tumor (3.7% v 20.0% in non-BMI cases). Eighty-seven of 108 (81%) assessable patients with BMI achieved a complete remission (CR). This compares favorably with the overall CR rate in all stage IIIB/IV patients. Among stage IV patients, BMI has no prognostic relevance with regard to freedom from treatment failure and overall survival. Twenty-one patients with BMI relapsed after having achieved a CR. Only five of these (24%) again had a positive bone marrow biopsy. CONCLUSION The prognosis of patients with BMI is not worse than the prognosis of other advanced-stage HD patients. BMI alone does not define a special high-risk group in which a different treatment approach is indicated.

Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy. A prospectively randomized study by the Cancer and Leukemia Group B.

1986 ◽  
Vol 4 (6) ◽  
pp. 838-846 ◽  
Author(s):  
V Vinciguerra ◽  
K J Propert ◽  
M Coleman ◽  
J R Anderson ◽  
L Stutzman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Disease Free Survival ◽  
Complete Response ◽  
Free Survival ◽  
Group B ◽  
Leukemia Group ◽  
Disease Free

A randomized clinical trial of combination chemotherapy for patients who relapsed following primary radiation therapy for Hodgkin's disease was conducted from 1975 to 1981 by the Cancer and Leukemia Group B (CALGB). One hundred thirteen patients were prospectively randomized to receive 12 cycles of either CVPP (CCNU, vinblastine, procarbazine, and prednisone), ABOS (bleomycin, vincristine [Oncovin; Lilly, Indianapolis], doxorubicin [Adriamycin, Adria Laboratories, Columbus, Ohio], and streptozotocin), or alternating cycles of CVPP and ABOS. The median length of observation for patients in this report is 4 years. Toxicities of the three treatment programs were primarily hematologic. Frequencies of complete response were 72% for CVPP, 70% for ABOS, and 82% for CVPP/ABOS (P = .37). Females and patients who had nodular sclerosing disease at initial diagnosis had significantly higher complete response rates. The 5-year disease-free survival for the complete responders was 55%; the 5-year overall survival was 60%. There were no significant differences among the treatments on disease-free survival (P = .78) or overall survival (P = .18). Age under 40 years was the only significant positive prognostic factor for disease-free survival (P = .095) and overall survival (P = .003). This study demonstrates no statistically significant advantage for alternating cycles of combination chemotherapy in affecting complete response frequency, disease-free survival, or overall survival as compared with therapy with CVPP or ABOS alone. However, the power to detect differences in these outcome parameters is somewhat limited by the sample sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

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