| Abstract |
Introduction: Hodgkin's lymphoma is a heterogeneous group of B-cell lymphomas. It affects 10% of lymphomas in the United States of America and is categorized according to the current WHO classification into two distinct groups: nodular lymphoma-predominant type and classic Hodgkin.
It presents high cure rates in both adult and pediatric populations. It shows a bimodal distribution of occurrence, with incidence increasing between ages 10 and 14, peaking between ages 20 and 24, and then decreasing in incidence until the 4th decade of life. A second peak begins at the end of the 4th decade of life and shows incidence rates similar to those of AYAs after age 65.
A special group of patients are adolescents and young adults (AYAs) with HL. The definition of AYAs includes patients of the solar group between 15 and 39 years of age. AYAs differ from the rest of the population in terms of their epidemiology, outcome and specific social circumstances, making them a more vulnerable group that needs further characterization of their disease. Aim: To make a retrospective study of the children, adolescents and young adults up to 39 years old who were diagnosed and treated with Hodgkin lymphoma at the Pediatric Hematology-Oncology Clinic and the Hematology Clinic of the University General Hospital of Heraklion and then a comparison of the epidemiological and clinical characteristics, the diagnostic approach , the therapeutic treatment as well as the outcome between the patients of the two clinics and also with the international literature.
Materials and methods: The study includes all patients up to 39 years old with Hodgkin lymphoma who, between 01/01/2013 and 31/12/2022, were referred to the Pediatric Hematology-Oncology Clinic and the Hematology Clinic of the University General Hospital of Heraklion. Patient demographics, epidemiologic and prognostic factors, clinical data, and available histologic features of lymphoma were recorded. Subsequently, the therapeutic approach, the time of response or relapse for each patient and the outcome in each case were recorded. Then, a statistical analysis of the data was performed and the results of the two clinics were compared. Finally, an attempt was made to correlate the existing literature with the collected data to derive comparative results.
Results: 55 patients with Hodgkin lymphoma participated in our study of which 17 were children and 38 adults. The average age of diagnosis was 20 years. 47 of the 55 patients belonged to the group of AYAs with a rate of 85.4%. 96.3% of patients were diagnosed with classical HL and 84.9% of them with nodular sclerosis subtype. 45.4% of the patients had b symptoms at the time of diagnosis, while the most frequent cause of presentation was cervical lymphadenopathy. 56.4% of patients underwent interim PET/CT after 2 cycles of OEPA or ABVD. 18.2% of patients experienced disease progression or relapse and 1 patient (1.81%) died. The epidemiological, histological and clinical characteristics of the patients in our study agree with the international literature. In our study, the 5-year disease-free survival was 81.8%, percentage that agrees with the literature, and the 5-year overall survival was 98.2%, which is higher than the overall survival of the international data.
Conclusion: The patients of the study were diagnosed and treated according to the international treatment protocols, presenting higher cure rates compared to the international literature. Several of the conclusions of the study agree with the international literature, while the differences with it are probably due to the small sample of the study and the lost medical records. Prospect would be the continuation of the registration for more years or with the participation of patients from other centers. Also, the addition of more information such as the cumulative doses of drugs and the correlation of them with toxicities would give us more and more reliable results.
|
Collections
