Hodgkin’s Disease (1975-2012): Long-Term Results of a Single Center

Aim: To investigate the clinical features, diagnostic and treatment results and long-survival of children with HL at a single center in Turkey.

Methods: Retrospective data were extracted from medical records of children (<18 years old) diagnosed and treated for HL between 1975 and 2012 at Istanbul University, Cerrahpasa Medical Faculty.

Results: Twohundred-fortyeight patients (M/F: 1.8) were identified for analysis. Mean age at diagnosis was 10 years. Four-percent were stage 1, 43% were stage 2, 34% were stage 3 and 17% were stage 4 at diagnosis. B symptoms were present in 105 children (42%). Mixed cellular was the most common subtype (50%) followed by nodular sclerosis. MOPP regimen was primarily used until 1989 along with extended field radiotherapy (30-40 Gy) after 1989 ABVD with involved field RT (20-25 Gy) was the treatment of choice. Onehundred-fortyseven patients (42%) had radiotherapy. Median follow-up time was 14.3 years (range: 5 months-38 years). PET was used for assessment in 45 cases. Ten year overall survival rate was 99%. Ten year event free survival rate (EFS) was 90%. Univariate analysis showed that stage, histological subtype, presence of B symptoms and hematological parameters were not related to OS while treatment regimen correlated. Twenty-six patients relapsed and 17 patients expired on follow-up. Ten patients who relapsed were treated with autologous stem cell transplantation, 3 of them relapsed again and were treated with brentixumab. Secondary tumours developed in 4 patients (1.6%). One had AML, 1 osteosarcoma, 1 thyroid papillary cancer and 1 had craniopharyngioma.

Conclusion: Ethnic and regional differences in the epidemiology and pathological aspects of HL may be associated with differences in clinical features and prognosis however we found that clinical features and treatment outcomes are similiar in Turkish patients. Our results showed that hematological parameters and B symptoms were not significant prognostic parameters.