Hodgkin lymphoma in very young children: Clinical characteristics and outcome of treatment

Belgaumi, Asim; Al-Kofide, Amani; Joseph, Nicey; Jamil-Malik, Rubina; Khafaga, Yasser; Sabbah, Rajeh

doi:10.1080/10428190801947492

Cited by 24 publications

(20 citation statements)

References 16 publications

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“…However, in the present study EBV+ cHL had a different and pronounced incidence peak at adolescence and was strongly associated with the MC subtype. This incidence peak of EBV+ cHL at young age closely resembles that seen in various developing regions in the world, including South America, Mexico and the Middle East and is associated with a low socioeconomic status and early exposure to EBV [24]–[30]. In both the Chinese and the Dutch populations a clear peak for EBV- NS patients was observed at the 3rd decade.…”

Section: Discussionsupporting

confidence: 71%

Epidemiology of Classical Hodgkin Lymphoma and Its Association with Epstein Barr Virus in Northern China

et al. 2011

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BackgroundThe incidence of classical Hodgkin lymphoma (cHL) and its association with Epstein-Barr virus (EBV) varies significantly with age, sex, ethnicity and geographic location. This is the first report on epidemiological features of cHL patients from Northern regions of China. These features are compared to data from a previously published Dutch cHL population.Methodology/Principal Findings157 cHL patients diagnosed between 1997 and 2008 in the North of China were included after histopathological re-evaluation. The Dutch population-based cohort consisted of 515 cHL patients diagnosed between 1987 and 2000. EBV status was determined by in situ hybridization of EBV- encoded small RNAs. In the Chinese population, tumor cells of 39% of the cHL patients were EBV+ and this was significantly associated with male sex, mixed cellularity subtype and young age (<20 y). The median age of the Chinese patients was 9 years younger than that of the Dutch patients (28 y vs. 37 y). In addition, the age distribution between the two populations was strikingly different in both the EBV+ subgroups (p<0.001) and the EBV- subgroups (p = 0.01). The mixed cellularity subtype was almost 3x more frequent amongst the Chinese (p<0.001).Conclusion/SignificanceCHL patients from Northern regions of China show a distinctive age distribution pattern with a striking incidence peak of EBV+ mixed cellularity cases among children and adolescents and another high incidence peak of EBV- nodular sclerosis cases in young adults. In comparison to Dutch cHL patients there are pronounced differences in age distribution, subtype and EBV status, presumably caused by complex gene-environmental interactions.

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Section: Discussionsupporting

confidence: 71%

Epidemiology of Classical Hodgkin Lymphoma and Its Association with Epstein Barr Virus in Northern China

et al. 2011

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“…Its incidence in childhood is higher in developing countries compared to developed countries, where it is mainly a disease of the young adult, with a second incidence peak after 40 years of age. It is treated with chemotherapy and/or radiotherapy [2] and survival rates of over 80% are achievable.…”

Section: Introductionmentioning

confidence: 99%

How much does it cost to treat children with Hodgkin lymphoma in Africa?

Stefan

Stones

2009

Leukemia & Lymphoma

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Hodgkin lymphoma (HL) is a common B-cell childhood neoplasm and it has a higher incidence in the 0-14 year age group in developing countries compared to developed countries. Treatment achieves a cure rate of about 80%. In African countries with a small gross domestic product per capita the cost of treating HL in children may be prohibitive. To determine the direct costs of treatment of HL in South Africa and to propose a more cost-effective approach to investigation and treatment for children diagnosed with HL in Africa, tumor registry data for 138 children with HL from two South African hospitals were analysed retrospectively. The cost of treatment for stage 2 disease was calculated, including investigations and chemotherapy. The analysis included the cost of a follow-up period of 2 years. Stage 2 was the most common stage seen, and ABVD protocol was the most common protocol used. The total cost of diagnosing, staging, treating with chemotherapy and following up a child with stage 2 HL for 2 years post-therapy was ZAR 53178.20 = USD 6647.27 = EUR 4431.51. Follow-up expenditure was much higher than initial chemotherapy costs. The major factors driving the cost for the whole group of 138 patients were as follows: stage, radiologic imaging, radiotherapy, second-line chemotherapy, hospitalisation and febrile neutropenia. The total cost of treatment of HL is affordable for first world countries, but it remains expensive for developing countries, especially in Africa where the GDP is often under USD 2000 per head. Early diagnosis, use of less toxic protocols such as ABVD, close monitoring to prevent complications and elimination of unnecessary tests and investigations may reduce the overall cost.

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“…HL represents approximately one‐third of lymphomas in children 11,15,16. CHL is more prevalent, with few studies reporting findings on nodular lymphocyte predominance during childhood 17–21.…”

Section: Introductionmentioning

confidence: 99%

Pediatric lymphomas in Brazil

Gualco¹,

Klumb²,

Barber³

et al. 2010

Clinics

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OBJECTIVE:This study provides the clinical pathological characteristics of 1301 cases of pediatric/adolescent lymphomas in patients from different geographic regions of Brazil.METHODS:A retrospective analyses of diagnosed pediatric lymphoma cases in a 10‐year period was performed. We believe that it represents the largest series of pediatric lymphomas presented from Brazil.RESULTS:Non‐Hodgkin lymphomas represented 68% of the cases, including those of precursor (36%) and mature (64%) cell origin. Mature cell lymphomas comprised 81% of the B‐cell phenotype and 19% of the T‐cell phenotype. Hodgkin lymphomas represented 32% of all cases, including 87% of the classical type and 13% of nodular lymphocyte predominant type. The geographic distribution showed 38.4% of the cases in the Southeast region, 28.7% in the Northeast, 16.1% in the South, 8.8% in the North, and 8% in the Central‐west region. The distribution by age groups was 15–18 years old, 33%; 11–14 years old, 26%; 6–10 years old, 24%; and 6 years old or younger, 17%. Among mature B‐cell lymphomas, most of the cases were Burkitt lymphomas (65%), followed by diffuse large B‐cell lymphomas (24%). In the mature T‐cell group, anaplastic large cell lymphoma, ALK‐positive was the most prevalent (57%), followed by peripheral T‐cell lymphoma, then not otherwise specified (25%). In the group of classic Hodgkin lymphomas, the main histological subtype was nodular sclerosis (76%). Nodular lymphocyte predominance occurred more frequently than in other series.CONCLUSION:Some of the results found in this study may reflect the heterogeneous socioeconomical status and environmental factors of the Brazilian population in different regions.

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Hodgkin lymphoma in very young children: Clinical characteristics and outcome of treatment

Cited by 24 publications

References 16 publications

Epidemiology of Classical Hodgkin Lymphoma and Its Association with Epstein Barr Virus in Northern China

Epidemiology of Classical Hodgkin Lymphoma and Its Association with Epstein Barr Virus in Northern China

How much does it cost to treat children with Hodgkin lymphoma in Africa?

Pediatric lymphomas in Brazil

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