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Developing anticancer chemotherapy services in a developing country: Hodgkin lymphoma experience
Author(s) -
Chandra Jagdish,
Naithani Rahul,
Singh Varinder,
Saxena Y.K.,
Sharma Manoj,
Pemde Harish
Publication year - 2008
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21609
Subject(s) - medicine , abvd , copp , chemotherapy , abdominal ultrasonography , lymphoma , neutropenia , nodular sclerosis , radiation therapy , surgery , hodgkin lymphoma , cyclophosphamide , vincristine , heme , biochemistry , chemistry , computed tomography , heme oxygenase , enzyme
Background and Objective Reporting on how the cancer treatment facilities were developed at a medical college hospital in India and the profile and outcome of patients with Hodgkin lymphoma (HL) at this new center were the objectives of the study. Methods Patients under 18 years with a diagnosis of HL were evaluated using abdominal ultrasonography, CT scan examination of chest, abdomen and pelvis and bone marrow examination. Most patients were treated with combination chemotherapy. Departments of Radiodiagnosis and Pathology were involved for evaluation. Radiotherapy when required was made available at a nearby hospital. Results Thirty‐five patients between 1.2 and 18 years (median age 7 years) were diagnosed as HL during the study period. Advanced disease (Stage IIb or more) was present in 83% cases. Mixed cellularity was the commonest histological subtype (50.5%). Primary therapy used was COPP in 29 (83%) cases. Of the 34 patients who received treatment 30 showed initial good response to therapy. One patient responded to ABVD after having progression on COPP. Of 31 responders, 4 relapsed. Twenty‐seven patients (80%) are surviving free of disease for a median follow up of 4.5 years (range 1.5–18 years). Chemotherapy was well tolerated. Febrile neutropenia occurred in four cases. Conclusions Pediatric HL in India was characterized by advanced disease at presentation. Mixed‐cellularity was the predominant histological subtype. An effective program was developed with initial attention to patients with HL. Pediatr Blood Cancer 2008;51:485–488. © 2008 Wiley‐Liss, Inc.