CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0041-1730240
Original Article

Role of Interim PET Scan after 2 Cycles of ABVD in Pediatric Hodgkin Lymphoma: Retrospective Multicenter Study from South India

Arun Seshachalam
1  Dr. GVN Cancer Institute, Tiruchirappalli, Tamil Nadu, India
,
Shashidhar V. Karpurmath
2  Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
,
Krishnakumar Rathnam
3  Meenakshi Mission Hospital and Research Center, Madurai, Tamil Nadu, India
,
Arathi Srinivasan
4  Kanchi Kamakoti CHILDS Trust Hospital, Nungambakkam, Chennai, Tamil Nadu, India
,
Julius Scott
5  Sri Ramachandra Medical Center, Porur, Chennai, Tamil Nadu, India
,
Raman S. G.
6  Madras Cancer Care Foundation, Chennai, Tamil Nadu, India
,
M. Janarthinakani
6  Madras Cancer Care Foundation, Chennai, Tamil Nadu, India
,
Krishna Prasad
7  Mangalore Institute of Oncology, Mangaluru, Karnataka, India
,
Channappa Patil
8  Apollo Hospital, Bengaluru, Karnataka, India
,
Parameswaran Anoop
8  Apollo Hospital, Bengaluru, Karnataka, India
,
Neelesh Reddy
9  Columbia Asia Hospital, Bengaluru, Karnataka, India
,
Satish Kumar Anumula
9  Columbia Asia Hospital, Bengaluru, Karnataka, India
,
Sirigeri Prabhakar Roopa
9  Columbia Asia Hospital, Bengaluru, Karnataka, India
,
Krishna Reddy Golamari
10  Manipal Hospital, Vijayawada, Andhra Pradesh, India
,
Madhav Danthala
10  Manipal Hospital, Vijayawada, Andhra Pradesh, India
,
Basawantrao Malipatil
9  Columbia Asia Hospital, Bengaluru, Karnataka, India
,
Bharath Rangarajan
11  Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
,
Karthik S. Udupa
12  Kasturba Medical College, Manipal, Karnataka, India
,
Manjunath Nandennavar
2  Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, Karnataka, India
,
Kesavan Niraimathi
13  Fenivi Research Solutions, Chennai, Tamil Nadu, India
› Author Affiliations
Funding Local investigators had the responsibility of collecting the data and entering into the database. Preexisting local resources were used to collect the required information. Hence, no funding was required for this research project

Abstract

Introduction Most Indian centers use Adriamycin/Bleomycin/Vinblastine/Dacarba-zine (ABVD) chemotherapy for pediatric Hodgkin lymphoma (pHL). To reduce the late toxicity, robust predictive markers are needed to risk stratify pHL patients, thereby limiting the number of chemotherapy cycles and omitting radiation for low-risk and intensifying treatment for high-risk children.

Objective This study was conducted to analyze the outcome of pHL patients treated with ABVD and various factors predicting the outcome.

Materials and Methods This retrospective study analyzed the outcome of 113 consecutive pHL children treated with ABVD chemotherapy from 11 tertiary care centers in South India from 2009 to 2019.

Results The median duration of follow-up was 2.73 years. The median age was 13 years. B symptoms are seen in 50.5% patients, bulky disease in 23%, and stage IV in 28.3%. Of 113 pHL, 69% had a positron emission tomography (PET) and 31% had computed tomography (CT)-based staging. Stage IV (37.1%) and extranodal involvement (31.2%) were seen more often with PET than with CT staging (8.5 and 2.8%, respectively). Among 64 patients with interim PET scan after two cycles (iPET2), 20.3% did not achieve complete remission (CR) and no factors were significantly associated. The 4-year event-free survival (EFS) rate of the entire cohort was 86%. The 4-year EFS rate was 93% for patients with CR in iPET2 and 52% for patients not achieving CR. The only independent predictor of low EFS was iPET2 response (p < 0.05).

Conclusion Our study confirms the prognostic role of PET scan staging and response assessment. Not achieving CR on the iPET2 scan indicates poor prognosis and warrants clinical trial enrollment for a better outcome.

Notes

*Both authors contributed equally to the manuscript.


Supplementary Material



Publication History

Publication Date:
06 July 2021 (online)

© 2021. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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