PEDIATRIC'HODGKIN'S'LYMPHOMA:'MONOCENTRIC'TUNISIAN'EXPERIENCE'
POSTER'32'
'
Raoudha! Mansouri,! Yasmine! Khayati,! Karima! Kacem,! Dorra! Jabr,! Emna! Barred,! Meriem! Achour,!
Salma!Kefi,!Manel!Bchir,!Marwa!Bahri,!Rachid!Kharrat,!Hend!Ben!Neji,!Yosr!Ben!Abdennebi,!Raihane!
Ben!Lakhal,!Lamia!Aissaoui!and!Balkis!Meddeb!
!
Aziza!Othmana!Hospital,!TUNIS,!Tunisia!
!
Pediatric!Hodgkin's!lymphoma!(PHL)!is!a!rare!disease,!which!in!more!than!90%!of!cases!the!
evolution!can!be!cured.!In!Tunisia,!the!management!of!pediatric!Hodgkin!lymphoma!is!based!
on! the! international! protocol:! the! EURONET! PHL! C1! protocol! since! 2012.! The! aim! of! this!
work!is!to!describe!the!epidemiological,!clinical!and!therapeutic!features!of!PHL.!
FortyJnine! patients! were! followed! at! the! clinical! hematology! department! at! the! Aziza!
Othmana!hospital!over!6!years.!Three!therapeutic!groups!(TG1,!TG2!and!TG3)!according!to!
the! Euronet! PHLJC1! protocolwere! identified.! They! received! two! OEPA! courses! followed! by!
an! evaluation! by! a! whole! body! scanner! (or! PET).! The! both! others! groups! (TG2! and! TG3)!
received!2!or!4!COPDAC!cycles,!respectively.!Radiotherapy!of!the!initially!affected!sites!(IAS),!
is!indicated!if!complete!response!not!achieved.!!
The!median!age!was!13!years!3J!17!years!with!a!sex!ratio:!1.59.!Sixteen!patients!had!B!signs!
(33%).!Twenty!six!children!had!at!least!two!lymph!node!areas!affected,!ie!55%.!Nine!children!
had!a!Bulky!(19%).!Ten!children!had!a!large!mediastinal!mass!(MTI≥0.35)!ie!21%.!ThirtyJtwo!
children!(66%)!had!ESR!≥!30!min.!Localized!stages!were!predominant!(33!children!or!67%).!
Sixteen!children!had!an!advanced!stage.!Ten!patients!belonged!to!the!TG1!group,!22!to!the!
TG2!group!and!17!to!the!TG3!group.!The!OR!after!the!2!OEPA!courses:!100%!(23!CR!and!26!
PR).!After!4!courses,!38!were!assessed!(1death!by!cardiac!toxicity):!84%!OR!(19!CR,!13PR).!
Seventeen! patients! were! assessed! after! 6! courses:! 76%! OR! (10CR,! 3! PR),! 4! were! not!
evaluated.!ThirtyJnine!patients!had!received!radiotherapy!for!IAS:!90%!OR!(36!CR!and!3!PR).!
Four!patients!were!in!progression!and!had!received!salvage!therapy:!one!patient!died!from!
the! disease! despite! 3! salvage! chemotherapy! lines,! one! patient! is! alive! after! achieving!
remission! with! Brentixumab! vedotin,! two! patients! are! living! in! remission! after! autologous!
stem!cells!transplantation.!Among!98!OEPA!cycles,!42%!of!neutropenia!occurred!(75%!WHO!
grade! 3J4).! Grade! 5! cardiac! toxicity! occurred! in! a! child! after! the! 2nd! OEPA! cycle.! Grade! 4!
neurological!toxicity!occurred!in!a!girl!requiring!therapeutic!adjustment.!The!median!followJ
up!is!38!months!9J75!months.!OS,!EFS,!and!RFS!are!93%,!80%,!and!93%,!respectively.!
The!results!confirm!the!good!prognosis!of!PHL.!The!current!challenge!is!to!limit!the!risk!of!
longJterm!toxicity!while!preserving!these!survival!rates.!
!!!!!!!!!!