J Korean Med Sci.  2020 Dec;35(46):e393. 10.3346/jkms.2020.35.e393.

Clinical Characteristics and Treatment Outcomes in Children, Adolescents, and Young-adults with Hodgkin's Lymphoma: a KPHOG Lymphoma Working-party, Multicenter, Retrospective Study

• Lee JM
• Choi JY
• Hong KT
• Kang HJ
• Shin HY
• Baek HJ
• Kim S
• Lee JW
• Chung NG
• Cho B
• Cho SG
• Park KM
• Yang EJ
• Lim YT
• Suh JK
• Kang SH
• Kim H
• Koh KN
• Im HJ
• Seo JJ
• Cho HW
• Ju HY
• Lee JW
• Yoo KH
• Sung KW
• Koo HH
• Park KD
• Hah JO
• Kim MK
• Han JW
• Hahn SM
• Lyu CJ
• Shim YJ
• Kim HS
• Do YR
• Yoo JW
• Lim YJ
• Jeon IS
• Chueh Hw
• Oh SY
• Choi HS
• Park JE
• Lee JA
• Park HJ
• Park BK
• Kim SK
• Lim JY
• Park ES
• Park SK
• Choi EJ
• Choi YB
• Yoon JH
• Kook H
• the Korean Pediatric Hematology and Oncology Group (KPHOG)

• KMID: 2509036
• DOI: http://doi.org/10.3346/jkms.2020.35.e393

Abstract

Background
Hodgkin's lymphoma (HL) constitutes 10%–20% of all malignant lymphomas and has a high cure rate (5-year survival, around 90%). Recently, interest has increased concerning preventing secondary complications (secondary cancer, endocrine disorders) in long-term survivors. We aimed to study the epidemiologic features and therapeutic outcomes of HL in children, adolescents, and young adults in Korea.
Methods
We performed a multicenter, retrospective study of 224 patients aged < 25 years diagnosed with HL at 22 participating institutes in Korea from January 2007 to August 2016.
Results
A higher percentage of males was diagnosed at a younger age. Nodular sclerosis histopathological HL subtype was most common, followed by mixed cellularity subtype. Eighty-one (36.2%), 101 (45.1%), and 42 (18.8%) patients were classified into low, intermediate, and high-risk groups, respectively. Doxorubicin, bleomycin, vinblastine, dacarbazine was the most common protocol (n = 102, 45.5%). Event-free survival rate was 86.0% ± 2.4%, while five-year overall survival (OS) rate was 96.1% ± 1.4%: 98.7% ± 1.3%, 97.7% ± 1.6%, and 86.5% ± 5.6% in the low, intermediate, and high-risk groups, respectively (P = 0.021). Five-year OS was worse in patients with B-symptoms, stage IV disease, highrisk, splenic involvement, extra-nodal lymphoma, and elevated lactate dehydrogenase level. In multivariate analysis, B-symptoms and extra-nodal involvement were prognostic factors for poor OS. Late complications of endocrine disorders and secondary malignancy were observed in 17 and 6 patients, respectively.
Conclusion
This is the first study on the epidemiology and treatment outcomes of HL in children, adolescents, and young adults in Korea. Future prospective studies are indicated to develop therapies that minimize treatment toxicity while maximizing cure rates in children, adolescents, and young adults with HL.

Keyword

Hodgkin Lymphoma; Children; Adolescent; Young Adult; Late Complication

Figure

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  Fig. 1 Distribution of histological sub-types of Hodgkin's lymphoma by age group.

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  Fig. 2 Treatment outcome of study patients. (A) Five-year OS and EFS of study patients, (B) OS according to risk factors (OS, P = 0.021), (C) EFS according to risk factors (EFS, P = 0.662), (D) EFS and OS of patients treated with HSCT, (E) OS of HSCT patients according to risk factors (P = 0.268).OS = overall survival, EFS = event-free survival, HSCT = hematopoietic stem cell transplantation.

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