Treatment of childhood Hodgkin lymphoma in sub-Saharan Africa: A report from the French-African Paediatric Oncology Group (GFAOP)

Abstract

Background . Childhood Hodgkin lymphoma (HL) is typically treated by chemo- and radiotherapy, depending on the stage of the disease. Studies on the treatment of HL by chemotherapy alone have shown encouraging results. Objective. To evaluate the feasibility, epidemiological and therapeutic aspects of paediatric HL treated with only COPP/ABV hybrid chemotherapy (cyclophosphamide, vincristine, procarbazine, prednisone, adriamycin, bleomycin and vinblastine). Methods. This was a prospective multicentre study on the management of HL in paediatric oncology centres of the French-African Paediatric Oncology Group in sub-Saharan Africa, from 1 October 2006 to 30 November 2012. To be included in the study, patients had to be younger than 18 years at diagnosis, with histologically proven HL. Results. A total of 106 patients were included, with a median age of 10 years (range: 2 - 18 years). The sex ratio was 3.1, with a preponderance of male patients (male: n =80; female: n =26). The largest number of patients were in stage IIIB ( n =47), IIB ( n =18) and IVB ( n =15); other stages were represented to a lesser extent. More than 80% of patients had an unfavourable initial prognosis. On biopsy, the nodular sclerosis subtype was observed in 36% of patients ( n =38), followed by mixed cellularity ( n =21; 20%) and the lymphocyte-rich subtype ( n =17; 16%). Eighteen patients relapsed. The overall survival rate of treated patients was 82% at a median follow-up of 30 months. Conclusion. The treatment of childhood HL in sub-Saharan Africa is challenging. The use of a hybrid chemotherapy protocol alone can be effective at improving patient survival