Evaluation of the Response to Chemotherapy in the Treatment of Hodgkin's Disease at the Mother and Child Center of the Chantal Biya's Foundation in Yaounde, Cameroon.

Abstract

Background: Hodgkin’s disease (HD) is a malignant disorder of the lymphatic tissue which mainly affects the lymph nodes and is characterized by a particular cell called Reed Sternberg cell. It represents 5% to 10% of malignancies in children with two peaks one around 6 years and the other around 14 years. Objective: The aim of the study was to evaluate the response of HD to a chemotherapy regimen without radiotherapy. Methods: We conducted a prospective study from 2007 to 2016. Were included, all records of patients admitted for Hodgkin's disease and having a histological evidence of HD. Children were treated with the protocol COPP/ABV at the Mother and Child Center of the Chantal Biya’s Foundation in Yaounde using only chemotherapy. Results: During that period, we collected 26 cases of HD. Which represented 1.96% of all cancers in children. The mean age at diagnosis was 11.6 years (7-16 years). The most represented age group was that of 10 to 14 with 57.7% of the cases. The sex ratio was 1.88. Forty-two per cent of patients had consulted more than 12 months after the beginning of symptoms. The circumstances of discovery were dominated by the appearance of peripheral adenopathies, particularly cervical (76.9%). Signs of clinical evolution were found at diagnosis in 61.5% of patients. The scleronodular, mixed cellular and the lymphocyte-rich forms were found in the following respective proportions: 38.4%, 34.6% and 27% and 82.60% of our patients were classified as unfavourable prognosis at the time of diagnosis. Overall survival at 5 years was estimated to be 82%. Conclusion: Hodgkin’s disease is a chemo sensitive and radiosensitive disease, for which most international protocols combine the two modalities of treatment. This study has demonstrated the feasibility of this modified treatment in our context where radiotherapy is unavailable.