Prognostic Impact of pathological subtypes in children with Classic Hodgkin Lymphoma: A comprehensive analysis

摘要

Introduction: Hodgkin lymphoma (HL) is a highly curable malignancy. Different pathological subtypes of classic Hodgkin lymphoma (CHL) are all treated with the same multimodality treatment, although they all do not have the same outcome. Our aim in this retrospective study was to highlight the presentation and prognosis of lymphocyte-depleted subtype and to compare it with the rest of subtypes in childhood CHL. Patients and methods : The data of 1197 children with biopsy-proven Hodgkin's lymphoma diagnosed from 2007 till 2017 at children cancer hospital Egypt were revised retrospectively. The outcome of different pathological subtypes are compared with other subtypes. Results: From a total of 1197 children with HL, ten patients (0.835%) were diagnosed as Lymphocyte Depleted Classic Hodgkin′s Lymphoma (LDCHL). All patients with LDCHL were diagnosed as high risk or advanced stages (3B, 4A, or 4B). Patients presented more often with advanced (high risk) disease as compared to other subtypes (100% versus 29.7%, respectively) and B symptoms (70% versus 32.3%, respectively). Risk factors as large mediastinal mass (50% versus 19%, respectively), high ESR (5 Out of 6 had elevated ESR), and involvement of more than three lymph nodes (80%). LDCHL cases showed an involvement of bone marrow in 22% of cases. The 5 years overall (OS) and Event-free survival (EFS) for LDCHL is the worst as compared to other pathologic subtypes CHL, 68.57% and 48% respectively. Conclusion : Children with LDCHL had a much aggressive presentation, responds inadequately to standard therapy, as well as having the worst outcome of all pathological subtypes CHL. Our results denote that children with LDCHL should receive more intensive chemotherapy.