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Results of GPOH-HD-2003 study in treatment of Hodgkin’s lymphoma in children and adolescents in the Morozovskaya Children’s Clinical Hospital

https://doi.org/10.21682/2311-1267-2020-7-31-40

Abstract

Relevance. Hodgkin’s lymphoma (HL) is a rare clonal neoplasm of lymphatic tissue. In the structure of malignant neoplasms in children HL accounts for 4–6 % and for 16 % in adolescents. Now children and adolescents with confirmed histology of HL in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital, treated with the GPOH-HD-2003 protocol. The authors of the article presented the experience of treatment children and adolescents with HL according to recommendations of GPOH-HD-2003 in the Department of Oncology and Hematology, Morozovskaya Children’s Clinical Hospital.

Patients and methods. From January 1, 2003 until December 31, 2018, 62 patients (35 boys, 27 girls) received therapy according to recommendations of GPOH-HD-2003 study. Age of patients ranges from 4.7 to 17.6 years, mean age was 13.3 years. All patients are allocated to three treatment groups (TGs) based on staging, in TG-1 were 2 patients, in TG-2 – 30 patients, in TG-3 – 30 patients. TG-1 patients received two courses of for induction: OEPA for boys and OPPA for girls. TG-2 and TG-3 patients received further two or four cycles COPP (girls) or COPDAC (boys), respectively. After chemotherapy all patients received initially involved-field irradiation with 19.8 Gy.

Results. CTCEA grade 1 or 2 hematotoxicity was the most common recorded adverse reaction in the OEPA regimen for boys, grade 3 or 4 hematotoxicity – in the OPPA regimen for girls. Also hematotoxicity was more pronounced with COPP than COPDAC. Overall (OS), event-free (EFS) and relapse-free (RFS) survival rates at 5 years were 100 % for the period of the observation time (the median observation time was 48.12 months). No treatment-related deaths, relapses or second malignancies were recorded during this period.

Conclusion. OS, EFS and DFS rates indicates high efficiency and low toxicity of GPOH-HD-2003 study regardless of the initial stage.

About the Authors

A. S. Naumova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Pediatric Oncologist, Head of the Center for Outpatient Cancer Care 

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



O. A. Tiganova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Cand. of Sci. (Med.), Pediatric Oncologist Department of Oncology and Hematology; Associate Professor, Department of Hospital Pediatrics No. 2

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia; 1 Ostrovityanova St., Moscow, 117997, Russia



L. I. Ilyenko
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Dr. of Sci. (Med.), Professor, Honored Doctor of the Russian Federation, Dean of the Faculty of Pediatrics

1 Ostrovityanova St., Moscow, 117997, Russia



D. B. Lavrukhin
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Leading Programmer IT Department

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



K. L. Kondratchik
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Cand. of Sci. (Med.), Head of Department of Hematology and Oncology; Associate Professor Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia; 1 Ostrovityanova St., Moscow, 117997, Russia



O. I. Baybak
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Pediatric Oncologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



G. O. Bronin
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Cand. of Sci. (Med.), Head of Hematopoietic Stem Cell Transplantation Department

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



M. A. Maltseva
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



G. N. Makhmudova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



T. Zh. Makhortykh
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Cand. of Sci. (Med.), Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



O. Yu. Mutorova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



N. V. Nepokulchitskaya
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Cand. of Sci. (Med.), Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



T. S. Sapelkina
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



I. Ya. Tomilin
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Pediatric Oncologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



O. Yu. Fuks
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Cand. of Sci. (Med.), Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



E. A. Shershakova
Morozovskaya Children’s Clinical Hospital, Department of Health in Moscow
Russian Federation

Hematologist Department of Oncology and Hematology

1/9 4th Dobryninskiy Per., Moscow, 119049, Russia



References

1. Kaatsch P. Epidemiology of childhood cancer. Cancer Treat Rev 2010;36(4):277–85. doi: 10.1016/j.ctrv.2010.02.003.

2. Arya L., Dinand V. Current Strategies in the Treatment of Childhood Hodgkin’s Disease. Ind Ped 2005;42:1115–28. PMID: 16340052.

3. Hochberg J., Waxman I.M., Kelly K.M., Morris E., Cairo M.S. Adolescent non-Hodgkin lymphoma and Hodgkin lymphoma: state of the science. Br J Haematol 2009;144(1):24–40. doi: 10.1111/j.1365-2141.2008.07393.x.

4. Ekstrand B., Horning S. Hodgkin’s Disease. Blood rev 2002;16(2):111–7. doi: 10.1054/blre.2002.0190.

5. Georgakis M.K., Karalexi M.A., Agius D., Antunes L., Bastos J., Coza D., Demetriou A., Dimitrova N., Eser S., Florea M., Ryzhov A., Sekerija M., Žagar T., Zborovskaya A., Zivkovic S., Bouka E., Kanavidis P., Dana H., Hatzipantelis E., Kourti M., Moschovi M., Polychronopoulou S., Stiakaki E., Kantzanou Μ., Pourtsidis A., Petridou E.T. Incidence and time trends of childhood lymphomas: findings from 14 Southern and Eastern European cancer registries and Surveillance, Epidemiology and End Results, USA. Cancer Causes Control 2016;27(11):1381–94. doi: 10.1007/s10552-016-0817-3.

6. Englund A., Glimelius I., Rostgaard K., Smedby K.E., Eloranta S., Molin D., Kuusk T., Brown P.N., Kamper P., Hjalgrim H., Ljungman G., Hjalgrim L.L. Hodgkin lymphoma in children, adolescents and young adults comparative study of clinical presentation and treatment outcome. Acta Oncol 2018;57(2):276–82. doi: 10.1080/0284186X.2017.1355563.

7. Dörffel W., Lüders H., Rühl U., Albrecht M., Marciniak H., Parwaresch R., Pötter R., Schellong G., Schwarze E.W., Wickmann L. Preliminary results of the multicenter trial GPOH-HD 95 for the treatment of Hodgkin's disease in children and adolescents: analysis and outlook. Klin Padiatr 2003;215(3):139–45. PMID: 12838937.

8. Shankar A.G., Kirkwood A.A., Hall G.W., Hayward J., O’Hare P., Ramsay A.D. Childhood and adolescent nodular lymphocyte predominant Hodgkin lymphoma – A review of clinical outcome based on the histological variants. Br J Haematol 2015;171(2):254–62. doi: 10.1111/bjh.13540.

9. Dieckmann K., Poetter R., Wagner W., Prott F.J., Hoernig-Franz I., Rath B., Schellong G. Up-front centralized data review and individualized treatment proposals in a multicenter pediatric Hodgkin’s disease trial with 71 participating hospitals: the experience of the German-Austrian pediatric multicenter trial DAL-HD-90. Radiother Oncol 2002;62(2):191–200. PMID: 11937246.

10. Mauz-Körholz C., Hasenclever D., Dörffel W., Ruschke K., Pelz T., Voigt A., Stiefel M., Winkler M., Vilser C., Dieckmann K., Karlén J., Bergsträsser E., Fossa A., Mann G., Hummel M., Klapper W., Stein H., Vordermark D., Kluge R., Körholz D. Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin’s lymphoma: the GPOH-HD-2002 study. J Clin Oncol 2010;28(23):3680–6. doi: 10.1200/JCO.2009.26.9381.

11. Rühl U., Albrecht M., Dieckmann K., Lüders H., Marciniak H., Schellenberg D., Wickmann L., Dörffel W. Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim reportat 5 years of the German GPOH-HD 95 trial. Int J Radiat Oncol Biol Phys 2001;51(5):1209–18. doi: 10.1016/s0360-3016(01)01798-9.

12. Zubizarreta P.A., Alfaro E., Guitter M., Sanchez La Rosa C., Galluzzo M.L., Millán N., Fiandrino F., Felice M.S. Children and Adolescent Hodgkin Lymphoma in Argentina: Long-term Results After Combined ABVD and Restricted Radiotherapy. J Pediatr Hematol Oncol 2017;39(8):602–8. doi: 10.1097/MPH.0000000000000943.

13. Marr K.C., Connors J.M., Savage K.J., Goddard K.J., Deyell R.J. ABVD chemotherapy with reduced radiation therapy rates in children, adolescents and young adults with all stages of Hodgkin lymphoma. Ann Oncol 2017;28(4):849–54. doi:10.1093/annonc/mdx005.

14. Kelly K.M., Sposto R., Hutchinson R., Massey V., McCarten K., Perkins S., Lones M., Villaluna D., Weiner M. BEACOPP chemotherapy is a highly effective regimen in children and adolescents with high-risk Hodgkin lymphoma: a report from the Children’s Oncology Group. Blood 2011;127(9):2596–603. doi: 10.1182/blood-2010- 05-285379.

15. Charpentier A.M., Friedman D.L., Wolden S., Schwartz C., Gill B., Sykes J., Albert-Green A., Kelly K.M., Constine L.S., Hodgson D.C. Predictive Factor Analysis of Response-Adapted Radiation Therapy for Chemotherapy-Sensitive Pediatric Hodgkin Lymphoma: Analysis of the Children’s Oncology Group AHOD 0031 Trial. Int J Radiat Oncol Biol Phys 2016;96(5):943–50. doi: 10.1016/j.ijrobp.2016.07.015.

16. Campo E., Swerdlow S., Harris N., Pileri S., Stein H., Jaffe E.S. The 2008 WHO classification of lymphoid neoplasms and beyond: evolving concepts and practical applications. Blood 2011;117(19):5019–32. doi: 10.1182/blood-2011-01-293050.

17. Korholz D., Kluge R., Wickmann L., Hirsch W., Luders H., Lotz I. Importance of F18-fluorodeoxy-D-2-glucose positron emission tomography (FDGPET) for staging und therapy control of Hodgkin’s lymphoma in childhood and adolescence – consequences for the GPOH-HD 2003 protocol. Onkologie 2003;26(5):489–93. doi: 10.1159/000072984.

18. Kluge R., Korholz D. Role of FDG-PET in staging and therapy of children with Hodgkin lymphoma. Klin Padiatr 2011;223(6):315–9. doi: 10.1055/s-0031-1287834.

19. Sickinger M.T., von Tresckow B., Kobe C., Borchmann P., Engert A., Skoetz N. PET-adapted omission of radiotherapy in early stage Hodgkin lymphoma – a systematic review and meta-analysis. Crit Rev Oncol Hematol 2016;101:86–92. doi: 10.1016/j.critrevonc.2016.03.005.

20. Isik E.G., Kuyumcu S., Kebudi R., Sanli Y., Karakas Z., Cakir F.B., Unal S.N. Prediction of outcome in pediatric Hodgkin lymphoma based on interpretation of 18 FDG-PET/CT according to ΔSUV max , Deauville 5-point scale and IHP criteria. Ann Nucl Med 2017;31(9):660–8. doi: 10.1007/s12149-017-1196-x.

21. Gobbi P.G., Ferreri A.J., Ponzoni M., Levis A. Hodgkin lymphoma. Crit Rev Oncol Hematol 2013;85(2):216–37. doi: 10.1016/j.critrevonc.2012.07.002.

22. Mathas S., Hartmann S., Küppers R. Hodgkin lymphoma: Pathology and Biology. Semin Hematol 2016;53(3):139–47. doi: 10.1053/j.seminhematol.2016.05.007.

23. Sherief L.M., Elsafy U.R., Abdelkhalek E.R., Kamal N.M., Elbehedy R., Hassan T.H., Sherbiny H.S., Beshir M.R., Saleh S.H. Hodgkin lymphoma in childhood: clinicopathological features and therapy outcome at 2 centers from a developing country. Medicine (Baltimore) 2015;94(15):e670. doi: 10.1097/MD.0000000000000670.

24. Kelly K.M. Hodgkin lymphoma in children and adolescents: improving the therapeutic index. Blood 2015;126:2452–8. doi: 10.1016/j.critrevonc.2012.07.002.

25. Trotti A., Byhardt R., Stetz J., Gwede C., Corn B., Fu K., Gunderson L., McCormick B., Morrisintegral M., Rich T., Shipley W., Curran W. Common toxicity criteria: Version 2.0 – An improved reference for grading the acute effects of cancer treatment: Impact on radiotherapy. Int J Radiat Oncol Biol Phys 2000;47(1):13–47. doi: 10.1016/s0360-3016(99)00559-3.


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For citations:


Naumova A.S., Tiganova O.A., Ilyenko L.I., Lavrukhin D.B., Kondratchik K.L., Baybak O.I., Bronin G.O., Maltseva M.A., Makhmudova G.N., Makhortykh T.Zh., Mutorova O.Yu., Nepokulchitskaya N.V., Sapelkina T.S., Tomilin I.Ya., Fuks O.Yu., Shershakova E.A. Results of GPOH-HD-2003 study in treatment of Hodgkin’s lymphoma in children and adolescents in the Morozovskaya Children’s Clinical Hospital. Russian Journal of Pediatric Hematology and Oncology. 2020;7(1):31-40. (In Russ.) https://doi.org/10.21682/2311-1267-2020-7-31-40

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