Skip to main content
SpringerLink
Log in
Book cover

Pediatric Hematology-Oncology in Countries with Limited Resources pp 257–269Cite as

Hodgkin Lymphoma

  • Chapter
  • First Online:

  • 1429 Accesses

Abstract

Hodgkin lymphoma (HL) in children and adolescents is one of the success stories in the quest to cure childhood cancer. However, this has not translated to all low and middle income countries (LMIC), where patients present with a long history of symptoms, in poor clinical condition with malnutrition, infections, signs of chronic illness, and advanced stages. Survival in LMIC is also hampered by lack of adequate diagnosis, staging, drug shortages, inadequate access to radiotherapy, delays in therapy, and social hardship leading to abandonment of therapy. Pathology confirmation is mandatory to establish the diagnosis of HL and is best accomplished when an excisional lymph node biopsy is done. Immunophenotyping is recommended for diagnosis but can often be made on an H&E stain. The incidence of HL across geographic regions varies, but it is curable even in countries with very limited resources with outcomes varying between 60 and 90 % survival with chemotherapy only or combined modality approaches. Outcomes for relapsed HL in LMIC are much worse than in HIC given the limitations of intensive cytoreduction and unavailability of autologous stem cell transplant and therefore the aim should be to achieve cure with frontline therapy. As more children become cancer survivors also in LMIC, awareness of long-term effects of therapy will become more and more important.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Stefan DC, Stones D. How much does it cost to treat children with Hodgkin lymphoma in Africa? Leuk Lymphoma. 2009;50:196–9.

    Article  PubMed  Google Scholar 

  2. Harif M, Trachli A, Quessar A, et al. Hodgkin’s disease in the very young child. Apropos of 11 cases. Bull Cancer. 1996;83:937–9.

    PubMed  CAS  Google Scholar 

  3. Stiller CA, Parkin DM. Geographic and ethnic variations in the incidence of childhood cancer. Br Med Bull. 1996;52:682–703.

    Article  PubMed  CAS  Google Scholar 

  4. Tanner J, Weis J, Fearon D, et al. Epstein-Barr virus gp350/220 binding to the B lymphocyte C3d receptor mediates adsorption, capping, and endocytosis. Cell. 1987;50:203–13.

    Article  PubMed  CAS  Google Scholar 

  5. Gandhi MK, Tellam JT, Khanna R. Epstein-Barr virus-associated Hodgkin’s lymphoma. Br J Haematol. 2004;125:267–81.

    Article  PubMed  CAS  Google Scholar 

  6. Maity A, Goldwein JW, Lange B, et al. Mediastinal masses in children with Hodgkin’s disease. An analysis of the Children’s Hospital of Philadelphia and the Hospital of the University of Pennsylvania experience. Cancer. 1992;69:2755–60.

    Article  PubMed  CAS  Google Scholar 

  7. Kurtin PJ, Pinkus GS. Leukocyte common antigen–a diagnostic discriminant between hematopoietic and nonhematopoietic neoplasms in paraffin sections using monoclonal antibodies: correlation with immunologic studies and ultrastructural localization. Hum Pathol. 1985;16:353–65.

    Article  PubMed  CAS  Google Scholar 

  8. Carbone PP, Kaplan HS, Musshoff K, et al. Report of the Committee on Hodgkin’s Disease Staging Classification. Cancer Res. 1971;31:1860–1.

    PubMed  CAS  Google Scholar 

  9. Hines-Thomas MR, Howard SC, Hudson MM, et al. Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin’s lymphoma. Haematologica. 2010;95:1691–6.

    Article  PubMed  Google Scholar 

  10. Vose JM, Link BK, Grossbard ML, et al. Long term follow-up of a phase II study of Rituximab in combination with CHOP chemotherapy in patients with previously untreated aggressive non-Hodgkin’s lymphoma (NHL). Blood. 2002;100:361A.

    Google Scholar 

  11. Metzger ML, Billett A, Link MP. The impact of drug shortages on children with cancer–the example of mechlorethamine. N Engl J Med. 2012;367:2461–3.

    Article  PubMed  CAS  Google Scholar 

  12. Castellanos EM, Metzger M, Baez LF, et al. A risk-adapted, response-based therapeutic regimen using a modified Stanford V approach for the treatment of children with high risk Hodgkin lymphoma, AHOPCA LH 2004, a therapeutic regimen from the Central America and Dominican Republic Association of Pediatric Oncology. In ASH Annual Meeting Abstracts Vol. 114; 2009. p. 718.

    Google Scholar 

  13. Metzger ML, Hudson MM, Krasin MJ, et al. Initial response to salvage therapy determines prognosis in relapsed pediatric Hodgkin lymphoma patients. Cancer. 2010;116:4376–84.

    Article  PubMed  Google Scholar 

  14. Moskowitz CH, Nimer SD, Zelenetz AD, et al. A 2-step comprehensive high-dose chemoradiotherapy second-line program for relapsed and refractory Hodgkin disease: analysis by intent to treat and development of a prognostic model. Blood. 2001;97:616–23.

    Article  PubMed  CAS  Google Scholar 

  15. Gorde-Grosjean S, Oberlin O, Leblanc T, et al. Outcome of children and adolescents with recurrent/refractory classical Hodgkin lymphoma, a study from the Societe Francaise de Lutte contre le Cancer des Enfants et des Adolescents (SFCE). Br J Haematol. 2012;158:649–56.

    Article  PubMed  Google Scholar 

  16. Schellong G, Dorffel W, Claviez A, et al. Salvage therapy of progressive and recurrent Hodgkin’s disease: results from a multicenter study of the pediatric DAL/GPOH-HD study group. J Clin Oncol. 2005;23:6181–9.

    Article  PubMed  Google Scholar 

  17. Bonfante V, Viviani S, Devizzi L, et al. High-dose ifosfamide and vinorelbine as salvage therapy for relapsed or refractory Hodgkin’s disease. Eur J Haematol Suppl. 2001;64:51–5.

    PubMed  CAS  Google Scholar 

  18. Cole PD, Schwartz CL, Drachtman RA, et al. Phase II study of weekly gemcitabine and vinorelbine for children with recurrent or refractory Hodgkin’s disease: a children’s oncology group report. J Clin Oncol. 2009;27:1456–61.

    Article  PubMed  CAS  Google Scholar 

  19. Santoro A, Bredenfeld H, Devizzi L, et al. Gemcitabine in the treatment of refractory Hodgkin’s disease: results of a multicenter phase II study. J Clin Oncol. 2000;18:2615–9.

    PubMed  CAS  Google Scholar 

  20. Santoro A, Magagnoli M, Spina M, et al. Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin’s lymphoma. Haematologica. 2007;92:35–41.

    Article  PubMed  CAS  Google Scholar 

  21. Donaldson SS, Link MP. Combined modality treatment with low-dose radiation and MOPP chemotherapy for children with Hodgkin’s disease. J Clin Oncol. 1987;5:742–9.

    PubMed  CAS  Google Scholar 

  22. Hudson MM, Neglia JP, Woods WG, et al. Lessons from the past: opportunities to improve childhood cancer survivor care through outcomes investigations of historical therapeutic approaches for pediatric hematological malignancies. Pediatr Blood Cancer. 2012;58:334–43.

    Article  PubMed  Google Scholar 

  23. Landier W, Bhatia S, Eshelman DA, et al. Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group Long-Term Follow-Up Guidelines from the Children’s Oncology Group Late Effects Committee and Nursing Discipline. J Clin Oncol. 2004;22:4979–90.

    Article  PubMed  Google Scholar 

  24. Castellanos EM, Barrantes JC, Baez LF, et al. A chemotherapy response based therapeutic approach to pediatric Hodgkin lymphoma using COPP regimen for favorable and COPP/ABV for unfavorable Hodgkin lymphoma in children and adolescents. An Association of Pediatric Hematology Oncology of Central America (AHOPCA) protocol: AHOPCA LH 1999. Pediatr Blood Cancer. 2013 (in press).

    Google Scholar 

  25. Sackmann-Muriel F, Zubizarreta P, Gallo G, et al. Hodgkin disease in children: results of a prospective randomized trial in a single institution in Argentina. Med Pediatr Oncol. 1997;29:544–52.

    Article  PubMed  CAS  Google Scholar 

  26. Sagar TG, Chandra A, Raman SG. Childhood Hodgkin disease treated with COPP/ABV hybrid chemotherapy: a progress report. Med Pediatr Oncol. 2003;40:66–9.

    Article  PubMed  CAS  Google Scholar 

  27. Al-Tonbary Y, Sarhan MM, El-Ashry RA, et al. Comparative study of two mechlorethamine, vincristine, procarbazine, and prednisone derived chemotherapeutic protocols for the management of pediatric Hodgkin lymphoma (HL): single-center 5-year experience. Leuk Lymphoma. 2010;51:656–63.

    Article  PubMed  CAS  Google Scholar 

  28. Madanat FF. MOPP therapy in children with Hodgkin’s disease. Am J Pediatr Hematol Oncol. 1989;11:407–10.

    PubMed  CAS  Google Scholar 

  29. Baez F, Ocampo E, Conter V, et al. Treatment of childhood Hodgkin’s disease with COPP or COPP-ABV (hybrid) without radiotherapy in Nicaragua. Ann Oncol. 1997;8:247–50.

    Article  PubMed  CAS  Google Scholar 

  30. Sripada PV, Tenali SG, Vasudevan M, et al. Hybrid (COPP/ABV) therapy in childhood Hodgkin’s disease: a study of 53 cases during 1989–1993 at the Cancer Institute, Madras. Pediatr Hematol Oncol. 1995;12:333–41.

    Article  PubMed  CAS  Google Scholar 

  31. Togo B, Traore F, Togo AP, et al. Hodgkin lymphoma at the paediatric oncology unit of gabriel toure teaching hospital, Bamako, Mali: 5-year experience. Adv Hematol. 2011;2011:327237.

    PubMed  CAS  Google Scholar 

  32. Chandra J, Naithani R, Singh V, et al. Developing anticancer chemotherapy services in a developing country: Hodgkin lymphoma experience. Pediatr Blood Cancer. 2008;51:485–8.

    Article  PubMed  Google Scholar 

  33. Arya LS, Dinand V, Thavaraj V, et al. Hodgkin’s disease in Indian children: outcome with chemotherapy alone. Pediatr Blood Cancer. 2006;46:26–34.

    Article  PubMed  Google Scholar 

  34. Belgaumi A, Al-Kofide A, Joseph N, et al. Hodgkin lymphoma in very young children: clinical characteristics and outcome of treatment. Leuk Lymphoma. 2008;49:910–6.

    Article  PubMed  CAS  Google Scholar 

  35. Olweny CL, Katongole-Mbidde E, Kiire C, et al. Childhood Hodgkin’s disease in Uganda: a ten year experience. Cancer. 1978;42:787–92.

    Article  PubMed  CAS  Google Scholar 

  36. Castellanos EM, Metzger ML, Fuentes S, et al. A Response-based ABVD regimen with or without radiotherapy for pediatric low and intermediate risk Hodgkin lymphoma in Central America and Dominician Republic. A report from AHOPCA. Pediatr Blood Cancer. 2012;59:977–8.

    Google Scholar 

  37. Hsu SC, Metzger ML, Hudson MM, et al. Comparison of treatment outcomes of childhood Hodgkin lymphoma in two US centers and a center in Recife, Brazil. Pediatr Blood Cancer. 2007;49(2):139–44.

    Google Scholar 

  38. Souza EM, Baiocchi OC, Zanichelli MA, et al. Comparison between hybrid MOPPABV and ABVD chemotherapy protocols for Hodgkin’s lymphoma in public hospitals of the largest South American city: a retrospective 14-year study. Ann Hematol. 2009;88:633–7.

    Article  PubMed  CAS  Google Scholar 

  39. Gao YJ, Tang JY, Pan C, et al. Risk-adapted chemotherapy without procarbazine in treatment of children with Hodgkin lymphoma. World J Pediatr. 2013;9:32–5.

    Article  PubMed  CAS  Google Scholar 

  40. El-Badawy S, Aboulnaga S, Abou GA, et al. Risk adapted combined modality treatment in children with Hodgkin’s disease: NCI, Cairo. J Egypt Natl Canc Inst. 2008;20:99–110.

    PubMed  Google Scholar 

  41. Alebouyeh M, Moussavi F, Haddad-Deylami H, et al. Successful ambulatory treatment of Hodgkin’s disease in Iranian children based on German-Austrian DAL-HD 85–90: single institutional results. Ann Oncol. 2005;16:1936–40.

    Article  PubMed  CAS  Google Scholar 

  42. Hessissen L, Oulhiane N, Elkhorassani M, et al. Pediatric Hodgkins disease in Morocco. Pediatr Blood Cancer. 2005;44:199.

    Article  PubMed  Google Scholar 

  43. Hessissen L, Khtar R, Madani A, et al. Improving the prognosis of pediatric Hodgkin lymphoma in developing countries: a Moroccan Society of Pediatric Hematology and Oncology study. Pediatr Blood Cancer. 2013;60(9):1464–9.

    Google Scholar 

  44. Ganesan P, Kumar L, Raina V, et al. Hodgkin’s lymphoma–long-term outcome: an experience from a tertiary care cancer center in North India. Ann Hematol. 2011;90:1153–60.

    Article  PubMed  Google Scholar 

  45. Buyukpamukcu M, Varan A, Akyuz C, et al. The treatment of childhood Hodgkin lymphoma: improved survival in a developing country. Acta Oncol. 2009;48:44–51.

    Article  PubMed  Google Scholar 

  46. Buyukpamukcu M, Atahan L, Caglar M, et al. Hodgkin’s disease in Turkish children: clinical characteristics and treatment results of 210 patients. Pediatr Hematol Oncol. 1999;16:119–29.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oncology, St Jude Children’s Research Hospital, University of Tennessee Health Sciences Center, Memphis, TN, USA

    Monika Metzger M.D.

  2. Centre Hospitalier Universitaire Mohammed VI, Marrakech, Morocco

    Mhamed Harif

Authors
  1. Monika Metzger M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mhamed Harif
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Monika Metzger M.D. .

Editor information

Editors and Affiliations

  1. Department of Paediatrics and Child Health, Stellenbosch University, Tygerberg Hospital, Tygerberg, South Africa

    Daniela Cristina Stefan

  2. Harvard Medical School, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, Boston, Massachusetts, USA

    Carlos Rodriguez-Galindo

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Metzger, M., Harif, M. (2014). Hodgkin Lymphoma. In: Stefan, D., Rodriguez-Galindo, C. (eds) Pediatric Hematology-Oncology in Countries with Limited Resources. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3891-5_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-3891-5_18

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-3890-8

  • Online ISBN: 978-1-4614-3891-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation