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The relation between the prognosis of childhood Hodgkin’s disease and haematological and other parameters

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Author(s): Tiraje Celkan | Safa Barış | Alp Özkan | Hilmi Apak | Ömer Doğru | Onur Bağcı | Sebuh Kuruoğlu | Hilal Akı | Mehmet Hallaç | İnci Yıldız

Journal: Turk Pediatri Arşivi
ISSN 1306-0015

Volume: 43;
Issue: 2;
Start page: 46;
Date: 2008;
Original page

Keywords: Childhood | hematological parameters | Hodgkin disease | prognostic values

ABSTRACT
Aim: Hodgkin’s disease (HD) is a common malignancy in children and is curable in over 90% of cases. At diagnosis prediction of the outcome is important to avoid overtreating some patients and identifying others who need more intensified chemotherapy. In this study, our aim is to determine the prognosis among relapsed, deceased and patients who are in remission, according to erythrocyte sedimentation rate (ESR), hemoglobin, leukocyte and lymphocyte levels that were taken at the time of diagnosis. Material and Method: There were 170 patients diagnosed as HD, admitted to Cerrahpaşa Faculty of Medicine, Pediatric Hematology and Oncology Department during 1975-2006. The records were reviewed retrospectively. Clinical evaluation and staging was performed in all patients. Disease staging was done according to Ann-Arbor classification system and histopathological subtypes were defined using Rye criteria. One hundred twenty six patients were eligible out of 170. Results: The mean age was 8.6+2.3 years and male/female ratio was 2.2 (87 males (70%) and 39 females (30%)). Staging was as follows: stage I; 3 (2%); stage II 83 (66%); stage III 24 (19%); stage IV 16 (13%). The most common histological subtype was mixed cellular (MC: 69, 55%), followed by nodular sclerosis (NS:35, 28%), lymphocyte predominance ( LP: 7, 5%) and lymphocyte depletion (LD: 3, 2%) with 12 unkown histology (9%)). The mean hemoglobin (Hb) levels were 10.7±2.17 gr/dl (4.5-13.5). Hb levels less than 10.5 gr/dl were found in 29 (23%). Mean leukocyte count were 7550±2170/mm3 (2100-21600/mm3), while leukocytosis (> 15 000/mm3) and lymphoctopenia (a lymphocyte count of less than 600/mm3) were rare (respectively; 7(5%), 1 (0.7%). Mean ESR of the group was found 55.53±38.6 mm/hour (median: 47, range:1-160). The ESR values of relapsed, expired or patients in remission were 52.4±31mm/h, 54.5±2mm/h and 53.8±3mm/h, respectively. Relapse occurred in 12(9.5%); 11 died (8.7%); and 103 patients (81.7%) were in remission. There was no difference between relapsed, dead or remission patients for any hematological parameters. Conclusion: It is found that hematological parameters in HD, which were investigated to predict prognosis, were not worthy in pediatric patients unlike adult patients. B sympotms and histological subtypes had no impaction prognosis while treatment regiment were associated with overal survi. (Turk Arch Ped 2008; 43: 46-9)

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