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

Affiliations
  • 1Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
  • 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
  • 3Seoul National University Cancer Institute, Seoul, Korea
  • 4Department of Pediatrics, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
  • 5Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 6Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 7Department of Pediatrics, Pusan National University School of Medicines, Yangsan, Korea
  • 8Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
  • 9Department of Pediatrics, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
  • 10Department of Pediatrics and Research Institute of Clinical Medicine of Jeonbuk National UniversityJeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Korea
  • 11Department of Pediatrics, Daegu Fatima Hospital, Daegu, Korea
  • 12Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
  • 13Division of Pediatric Hematology and Oncology, Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
  • 14Department of Pediatrics, Keimyung University School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 15Division of Hemato-oncology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
  • 16Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea
  • 17Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Korea
  • 18Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
  • 19Department of Hematology, Dong-A University Hospital, Busan, Korea
  • 20Department of Pediatrics, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
  • 21Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
  • 22Center for Pediatric Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • 23Department of Pediatrics, Inha University Hospital, Incheon, Korea
  • 24Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea
  • 25Department of Pediatrics, School of Medicine, University of Ulsan, Ulsan, Korea
  • 26Department of Pediatrics, Daegu Catholic University School of Medicine, Daegu, Korea
  • 27Department of Pediatrics, Chungbuk National University Hospital, Cheongju, Korea
  • 28Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea

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
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