在资源有限的国家采用基于反应的方法治疗小儿霍奇金淋巴瘤

Usama Al‐Jumaily, Hamid D. Habeeb Rjeib, Sabah Al-Mosawy, Safa Faraj, Monika Metzger
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引用次数: 0

摘要

背景:发展中国家对霍奇金淋巴瘤(HL)的治疗各不相同。本观察性研究旨在介绍接受各种化疗组合的霍奇金淋巴瘤患儿的治疗结果。无论风险分类如何,均采用基于反应的方法。材料和方法:我们招募了 2014 年 1 月至 2021 年 12 月期间在伊拉克一家癌症中心确诊为 HL 的 18 岁以下患者。通过对患者进行分层,确定了三个风险类别。每位患者首先接受两个周期的 ABVD 诱导化疗。诱导化疗后,出现完全放射学反应的患者继续接受4-6个周期的ABVD化疗,但不接受放疗。初始反应轻微的患者在接受第三个周期的ABVD化疗后,再接受三个疗程的COPDac化疗,然后接受放疗。研究结果本研究共纳入 59 名患者,中位年龄为 7 岁。III 期患者占 33.9%(20 人),其次是 II 期(32.2%)。25名患者出现B症状。有 11 名儿童最初受累于脾脏。52名患者(n=19;32.2%)有大块病变。混合细胞性是最常见的组织形态(n=44)。中位随访时间为2.7年。有效生存率为78%±10%,5年估计生存率为92%。大块病变是对结果产生重大不利影响的唯一因素。结论在资源有限的国家,以反应为基础的方法是防止不必要的放疗造成长期后遗症的重要策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Response-Based Approach for Pediatric Hodgkin Lymphoma in Nations with Restricted Resources
Background: Hodgkin lymphoma (HL) management varies throughout developing nations. This observational study aims to present the results of children having HL who received various combinations of chemotherapy treatment. The response-based method was used regardless of the risk classification. Materials and Methods: We recruited patients≤ 18 years of age diagnosed with HL in an Iraqi cancer center between January 2014 and December 2021. By stratifying patients, three risk categories were identified. Every patient initially received two cycles of ABVD as induction chemotherapy. Following induction chemotherapy, patients showing a full radiological response continued on ABVD chemotherapy for 4-6 cycles without receiving radiotherapy. Patients showing a modest initial response received three additional courses of COPDac next to the third cycle of ABVD, followed by radiotherapy. Results: This study included fifty-nine patients with a median age of 7 years. Stage III patients accounted for 33.9% (n=20), then stage II (32.2%). B symptoms were present in 25 patients. Eleven children had initial splenic involvement. Fifty-two individuals (n = 19; 32.2%) had bulky disease. Mixed cellularity was the most prevalent histology (n=44). The median duration of follow-up was 2.7 years. EFS was 78% ±10%, and survival was 92% at 5-year estimation. Bulky disease was the only factor with a substantial unfavorable impact on the result. Conclusion: Response-based approach is a valuable strategy in nations with limited resources to prevent long-term sequelae from unnecessary radiotherapy.   
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