Outcome of Hodgkin's Disease in Children with Chemotherapy alone in a Resource Limited Country

Abstract

Background: Treatment of Hodgkin's lymphoma involves both chemotherapy and radiotherapy. But radiotherapy in children is associated with risk of development of long-term complications like the development of second malignancy. Novel therapeutic strategies with combination chemotherapy without radiotherapy are being used to reduce such complications while maintaining the optimum response. Objective: To investigate the outcome of treatment of Hodgkin's Lymphoma with combination chemotherapy ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) alone.  Patients and methods: A quasi-experimental open label clinical study was done on 48 children with Hodgkin's lymphoma in the Paediatric Haemato-Oncology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) with eight cycle ABVD regime on an outpatient basis over a period of 8 months to see the outcome of treatment. Results: The mean age of the patients was 10.3 years (range 3-16). There were 42 males and 6 females. Mixed cellularity cHL was the commonest histological subtype observed 20/48 (42%) patients. Forty-two (88%) patients achieved complete response (CR), 5 (10%) had partial response (PR) and one patient did not respond at all. Fifteen patients (31%) are known to be dead and the rest are alive and tumour free. Median EFS and OS were not achieved. The EFS and OS at 5 years were 63% and 67% respectively. Conclusion: ABVD combination should be regarded at the present moment as the simplest and most effective drug therapy for treating childhood Hodgkin's disease.