Value of pathological staging and long term results of pediatric Hodgkin's disease

This is a retrospective study which included 86 pediatric patients with histopathological diagnosis of Hodgkins disease treated at treatment was 97.7% [84 cases] with complete response rate of 64% and partial response rate of 33.7%. Sixty two patients were evaluable for long term survival and 79% [49 patients] were alive for a mean follow up of 62 months. The disease free survival was 54.8% with a mean follow up of 60 months. The disease free survival for pathologically confirmed stages was 85.7% while for those clinically confirmed 45.8% [P< 0.05]. Combined modality treatment [radio-and chemotherapy] lead to a higher total and disease free survival 92% and respectively than single treatment modality. Number of lymph nodes involved, pathological subtypes and staging methods of cases with stage II disease adversely affect the actuarial total survival while age and staging method of cases with stage II disease adversely affect the actuarial free survival. Multivariate analysis revealed that age, B-symptoms and staging methods of cases with stage I and II affect the disease free survival. These factors should be taken into consideration when planning a new protocol regimen for pediatric Hodgkin's disease

Late effects of radiation and chemotherapy on children with malignant lymphomas

This study included all survival children [18 patients] with histopathological diagnosis of malignant lymphomas and treated during the period 1974-1985 inclusive. Follow up assessment was carried between July 1988 to the end of December 1988 to search for the treatment complications. Twelve out of 18 children [55.6%] showed late sequelae. Combined hypogonadism and stunted growth was the commonest 4/18 [22.2%] followed by hypognadism [11.1%], hypothyroidism [11.1%] while stunted growth alone and subcutaneous fibrosis occurred only in one patient [5.6%]. Complications related to combined treatment appeared in 7/11 cases [63.6% while appeared in 2/4 [50%] for those treated by chemotherapy and 1/3 cases [33.3%] for those treated by radiotherapy. Follow up period proved to be a statistically significant factor for detecting such complications as 85.7% [6/7] of cases followed for moor than 5 years showed complications versus 36.4% [4/11] of cases followed less than 5 years. There was no statistically significant effect in I.Q. of children who received prophylactic cranial irradiation

Value of protocol treatment of pediatric non-Hodgkin's lymphoma

The present study included 77 cases of pediatric Non-Hodgikn's lymphoma [NHL]. Twelve patients had received precious treatment elsewhere and were referred for salvage treatment after relapse. The remaining 65 patients were fresh cases. Fifty five percent of the whole group presented in abdominal sites. The commonest histological type in this group was undifferentiated NHL. Lymphobloastic lymphoma was the most common histological subtype among extra-abdominal presentation. Thirteen patients did not attend to receive their full treatment program and were excluded from further analysis. Treatment was given either on protocol basis [33 cases] or on individual non protocol basis [19 cases]. Complete remission [C.R.] was achieved in 78.7% [26/33] in the protocol group versus 16% [3/19] in nonprotocol cases [P< 0.001]. No single case of C.R. could be obtained with salvage treatment. Details of treatment programs and their outcome are discussed

Orbital non-hodgkin's lymphomas clinical characteristics, results of treatment and prognostic factors

Twenty one patients with histologically proven orbital NHL attending NEMROCK over a 10 year period [1980-1989] are analyzed. Orbital NHL constituted 2.4% of all NHL cases. the orbit was the fifth common extranodal site. The intermediate grade histology was the most frequent histopathological type [47.7%]. In this study, 57% of patients had localized disease, 43% showed disseminated disease in the lymph nodes, CNS, bone and bone marrow. Twenty patients were evaluable for assessment of treatment results, the overall 9-year actuarial survival was 68% with a mean duration of follow-up of 58 +/- 18 months [range 12-108 months]: the 9-year actuarial disease free survival was 56.4% with a mean follow up period of 62 +/- 20 months [range 12-108 months]. Histopathological subtype and disease extent were the two significant risk factors determining prognosis in this series of orbital NHL