Management Therapeutic Aspects in Hodgkin’s Lymphoma in Children

Abstract

Hodgkin's lymphoma (HL), also known as Hodgkin's disease, is a neoplasia of the lymphoid tissue with a variable evolution, and a much-improved prognosis under the conditions of modern treatment. The histological characteristic of the disease is represented by multinucleated giant cells, Reed-Sternberg, located in an environment of inflammatory cells, namely small lymphocytes, histiocytes, neutrophils, eosinophils, plasma cells and fibroblasts. The tumor cells specific to the majority of Hodgkin's lymphoma cases (approximately 98%) are formed from the germinal center of B cells that are not capable of synthesizing immunoglobulins. Current treatment programs use therapy based on individual risk factors and response to treatment, in which patients are treated with multiple chemotherapy agents with or without low-dose loco-regional radiotherapy. The prognostic factors used in determining the intensity of chemotherapy are represented by the stage of the disease, the presence or absence of B symptoms (fever, weight loss, sweating), as well as the presence of bulky tumor masses. The treatment of Hodgkin's lymphoma is one of the success stories of modern medicine. Hodgkin's disease is among the curable forms of childhood cancer, with a 5-year survival rate that can reach a percentage of 98%. [1] In this paper, we followed the evolution of 76 patients with Hodgkin's lymphoma, hospitalized at the Fundeni Clinical Institute, between January 2005 and December 2015. These patients were diagnosed and treated according to current diagnostic and therapeutic protocols. A large part of the patients in the low-risk group showed a favorable response to the administration of the ABVD chemotherapy regimen, and the majority of patients in the intermediate and high-risk groups received combined chemotherapy regimens, with or without loco-regional radiotherapy, having a positive response to this therapeutic strategy. Retrospectively collected data were obtained from the analysis of patient observation sheets. These data include quantitative and qualitative variables. These represent the factors that influence or determine the development directions of each of the stages of the study. Quantitative variables are discrete (integer) or continuous (any value) - age, date of admission, number of leukocytes at diagnosis, number of various chemotherapy courses used in the treatment, period of follow-up of the effectiveness of the therapy (days, weeks, months, years), etc. Qualitative variables are ordinal or nominal – sex, environment of origin, presence or absence of general symptoms at diagnosis, histopathological diagnosis, response to treatment, complications, etc.

Keywords

• lymphoma
• management
• adenopathy