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Isolated parenchymal lung involvement in children with stage IV Hodgkin's disease: results of the UKCCSG HD8201 and HD9201 studies
Author(s) -
Atra Ayad,
Higgs Elizabeth,
Capra Michael,
Elsworth Ann,
Imeson John,
Radford Martin,
Pinkerton Ross,
Hewitt M.
Publication year - 2002
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2002.03827.x
Subject(s) - medicine , procarbazine , stage (stratigraphy) , chlorambucil , vinblastine , lung , prednisolone , myeloid leukaemia , chemotherapy , radiology , gastroenterology , surgery , vincristine , paleontology , biology , cyclophosphamide
Summary. We retrospectively reviewed the case notes of 27 patients who were diagnosed with stage IV Hodgkin's disease (HD) because of isolated parenchymal pulmonary involvement on chest radiograph and computerized tomography scan (excluding subcategory E). Ten were boys and 15 had B symptoms. Median age at diagnosis was 13·6 years (range 6·1–16·2). All received 6–8 cycles of ChlVPP (chlorambucil, vinblastine, procarbazine and prednisolone) and two had additional whole lung irradiation (12 Gy). Ten patients (37%) relapsed or progressed. Seven survive following second‐line therapy while three died, two of HD and one of secondary acute myeloid leukaemia 4 years from diagnosis. At the time of analysis, the median follow‐up of patients was 56 months (range 9–127). The event‐free survival (EFS) was 58·4% (95% CI 38·5–75·8%) at both 5 and 10 years from diagnosis, and the overall survival (OS) was 84·2% (95% CI 61·8–94·6%) at both 5 and 10 years from diagnosis. We conclude that the outcome for HD patients defined as stage IV, because of isolated parenchymal lung involvement, is encouraging and compares favourably with other extra lymphatic organ involvement. Combination chemotherapy is effective in achieving long‐term remission and whole lung irradiation is unnecessary.