HL-290: Prognostic Impact of CD20 Positivity on Outcomes in Pediatric Hodgkin Lymphoma

Abstract

Context In adults, CD20-positive Hodgkin lymphoma (HL) has shown a trend toward better overall survival, though it has limited applications in the current treatment protocols. Studies on the impact of CD20 positivity on outcomes of pediatric HL is limited. Objective The primary objective was to compare the overall survival (OS) and event-free survival (EFS) of CD20-positive and -negative patients in pediatric HL. The secondary objective was to compare clinical presentation and stage between the two groups. Design We retrospectively reviewed the records of patients less than or equal to 18 years of age diagnosed with HL during the period of August 2003 to December 2018. Patients who were lost to follow-up were excluded. CD20 positivity was determined based on cutoff of 10% positivity. EFS and OS were evaluated by Kaplan-Meier methods. Clinical presentation and stage were compared between the two groups using the Chi-squared test. Setting The study was done at a tertiary care centre. Results The total number of patients were 299 with a median age of 10 years with predominantly males (84%). Eighty-five (28.43%) patients were CD20-negative. There was no significant difference in age, sex, B symptoms, bone marrow involvement, extra-nodal involvement, infra-diaphragmatic disease, liver involvement and stage between CD20-positive and CD20-negative patients. Splenic involvement was higher in CD20-negative patients compared to CD20-positive patients (82.7% vs 17.3%, p =0.001). Twenty-six patients progressed, nine of whom died. The total number of deaths were 12, nine of whom died due to disease and three of whom died due to bleomycin toxicity. Median follow up duration was 5.9 years. Median EFS and OS was not reached. There was no significant difference between EFS (HR: 0.96, CI: 0.43–2.18, p= 0.93) and OS (HR: 0.52, CI: 0.11–2.37, p=0.36) between CD20-positive and -negative patients. Conclusions We report the largest data on impact of CD20 in pediatric HL in this study. Splenic involvement was higher in CD20-negative patients. There was no significant difference in EFS and OS of CD20-positive patients in pediatric HL, the number of events being a limitation. Our study suggests that CD20 does not influence clinical outcome.