engleski

Treatment of childrens Hodgkin lymphoma in Croatia

According to very good reaction on chemotherapy and radiotherapy in children with Hodgkin disease, we are tgrying to find out the stage and subtype of the disease, and use the less aggressive but very effective therapy which will cure a large number of patients with less side effects. Purpose: To describe the Croatia experiance in the treatment children's with Hodgkin's disease. They were staged and treated in a single institution. Patients and Methods: At the hematologyagreb, Croatia in the period of 1990-2002 54 children (29 male and 25 female, median age at diagnosis was 12.1(2.5-18.0 y.) with HD have been treated with the combinatiuon of cytostatic therapy (OPPA, OEPA AND COOP) and radiotherapy( involved field radiation). Patients were allocated to 3 treatment group (TG) by disease stage: TG1, stage I and IIA, TG2 stage IIEA, IIB and IIIA and TG3, stage IIEB, IIIB, IIIE and IV. All patients underwent initially 2 cycle of OPPA or OEPA. In TG1 no further chemotherapy was given, patients in TG2 and TG3 received additional 2 opr 4 cycles of COPP. The distribution of the patients was: TG1, 21=39%, TG2, 19=35%, TG3, 14=26%. Radiotherapy was administered to the initially involved sites. Standard dosage was 20 Gy. Results: The remission has been achived in all patients: in 5 relapse appeared due to which considerably more aggressive cytostatic therapy as well as radiotherapy were applied: in 3 of them together with bone marrow transplantation ; 2 patients died. 52 patients are still alive in the first or the second remission. Serious side effects were not noticed. Secondary malignancies did not occure in any of patients. Conclusion: Combined modality therapy using risk-adapted low-dose, involved field radiotherapy + chemotherapy is optimal treatment for the majority of children with Hodgkin's disease.

Children; Hodgkin lymphoma; Treatment

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