Reviewing outcomes for children and adolescents with Hodgkin’s lymphoma

This article reviewed treatments and outcomes for children and adolescents with Hodgkin’s lymphoma (HL). The authors found that chemotherapy alone was a common treatment and that outcomes have improved for these young patients.

Hodgkin’s lymphoma (HL) is a cancer of the white blood cells. It can affect both children and adults and is the most common type of cancer in adolescents. Since the 1970s, the doses of radiation and chemotherapy used to treat HL have decreased. This lessens side effects, such as secondary cancer and infertility, without lowering effectiveness. It is unclear how outcomes in young adults with HL have changed over time.

This study looked at the records of 2619 patients younger than age 25. 436 children (under age 15), 490 adolescents (age 15 – 17) and 1693 young adults (age 18 – 24) were included. Patients were followed up for an average of 12.7 years.

The number of patients treated in university medical centers has increased. The number of adolescents treated in this setting went from under half in 1998 to 85% in 2007.

The use of radiation has decreased. However, the number of patients receiving chemotherapy alone has increased. Among children with early-stage HL, more patients received chemotherapy from 2010 – 2015 (68%) compared to 55% in the early 90s.

The number of patients who survived for at least 5 years after treatment also improved. Among patients with stage 2 disease, 5-year survival increased from 91% to 99%. Among patients with stage 3 disease, 5-year survival increased from 90% to 96%. Among patients with stage 4 disease, 5-year survival increased from 79% to 95%.

The chances of surviving for 10 years has increased. For adolescents, survival increased from 80% to 95%. For young adults, the chances of surviving 10 years increased from 88% to 94%.

149 patients had nodular lymphocytic predominant HL (NLPHL). Outcomes for these patients could not be analyzed because of the small number of patients. However, all of these patients were still alive 10 years later.

This study found that chemotherapy alone was a common treatment for patients with HL under age 24. The authors suggest that outcomes have improved over the years for these young patients.

This study used the records of all young patients treated in the Netherlands between 1990 and 2015. Including data from a complete population is a strength of the study. However, treatment may be different in other countries.