Contributions
Abstract: PB1556
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
The pediatric Hodgkin lymphoma (PHL) treatment particularity is to guarantee the efficacy with toxicity reduction. This was the objective of the first European protocol of PHL treatment: Euronet-PHL-C1. It consisted of the early FDG-PET response assessment. The indication for radiotherapy is based on early response evaluation by TEP scan. In Tunisia, the Euronet-PHL-C1 protocol has been used since 2012 with some modification because of the difficulty of the FDG-PET access. So, the early response assessment was based on whole body CT scan and the radiotherapy was maintained.
Aims
The objectives of the study were to analyze the characteristics of PHL and the therapeutic response.
Methods
A retrospective study was involving 49 patients, with PHL, treated with Euronet-PHL-C1 protocol modified, in the clinical hematology department of Aziza Othmana Hospital of Tunis, between 2013 and 2019.
Results
The median age was 13 years with a sex ratio of 1.59. Twenty-two children had less than 2 lymph nodes regions affected. Thirty-two patients didn’t have B symptoms. Ten had a large mediastinum in the chest x-ray. Thirty- two had an ESR≥ 30mm. Localized stages represented the majority (67%). Twenty-two had a CHIPS score between 1 and 4 (i.e. 24%). Nine patients belonged to therapeutic groups TG1 group, 24 to TG2 group and 16 to TG3 group. All the three TG received two OEPA cycles. The TG2 and TG3 received after the both OEPA courses, 2 and 4 COPDAC courses, respectively. The radiotherapy of in-volved fields (IF) is done for all TG. The assessment is based on whole body CT scan. The overall response rate (ORR) after 2 OEPA courses was 100%. The ORR after 2 COPDAC regimens was 95%. The ORR after 4 COPDAC regimens was 100%. Forty among the 49 patients received a radiotherapy of involved fields. Four patients (8%) had a pro-gressive disease: two during the chemotherapy and two before the radiotherapy. These patients belonged to the high risk relapse group of the Euronet-PHL-C1 protocol (RG3) and were in indication for treatment intensification. The Overall survival rate (OS), the event free survival (EFS) and the relapse free survival (RFS) were respectively, 95%, 80% and 99%.
Conclusion
PHL had a good prognosis. To maintain these excellent results and to limit the long-term consequences by using the FDG-PET to omit the radiotherapy.
Keyword(s): Chemotherapy, Hodgkin's lymphoma, PET, Radiotherapy
Abstract: PB1556
Type: Publication Only
Session title: Hodgkin lymphoma - Clinical
Background
The pediatric Hodgkin lymphoma (PHL) treatment particularity is to guarantee the efficacy with toxicity reduction. This was the objective of the first European protocol of PHL treatment: Euronet-PHL-C1. It consisted of the early FDG-PET response assessment. The indication for radiotherapy is based on early response evaluation by TEP scan. In Tunisia, the Euronet-PHL-C1 protocol has been used since 2012 with some modification because of the difficulty of the FDG-PET access. So, the early response assessment was based on whole body CT scan and the radiotherapy was maintained.
Aims
The objectives of the study were to analyze the characteristics of PHL and the therapeutic response.
Methods
A retrospective study was involving 49 patients, with PHL, treated with Euronet-PHL-C1 protocol modified, in the clinical hematology department of Aziza Othmana Hospital of Tunis, between 2013 and 2019.
Results
The median age was 13 years with a sex ratio of 1.59. Twenty-two children had less than 2 lymph nodes regions affected. Thirty-two patients didn’t have B symptoms. Ten had a large mediastinum in the chest x-ray. Thirty- two had an ESR≥ 30mm. Localized stages represented the majority (67%). Twenty-two had a CHIPS score between 1 and 4 (i.e. 24%). Nine patients belonged to therapeutic groups TG1 group, 24 to TG2 group and 16 to TG3 group. All the three TG received two OEPA cycles. The TG2 and TG3 received after the both OEPA courses, 2 and 4 COPDAC courses, respectively. The radiotherapy of in-volved fields (IF) is done for all TG. The assessment is based on whole body CT scan. The overall response rate (ORR) after 2 OEPA courses was 100%. The ORR after 2 COPDAC regimens was 95%. The ORR after 4 COPDAC regimens was 100%. Forty among the 49 patients received a radiotherapy of involved fields. Four patients (8%) had a pro-gressive disease: two during the chemotherapy and two before the radiotherapy. These patients belonged to the high risk relapse group of the Euronet-PHL-C1 protocol (RG3) and were in indication for treatment intensification. The Overall survival rate (OS), the event free survival (EFS) and the relapse free survival (RFS) were respectively, 95%, 80% and 99%.
Conclusion
PHL had a good prognosis. To maintain these excellent results and to limit the long-term consequences by using the FDG-PET to omit the radiotherapy.
Keyword(s): Chemotherapy, Hodgkin's lymphoma, PET, Radiotherapy