Hodgkin's disease in children in Southern Africa: Epidemiological characteristics, morbidity and long-term outcome

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dc.contributor.authorHesseling P.B.
dc.contributor.authorWessels G.
dc.contributor.authorVan Jaarsveld D.
dc.contributor.authorVan Riet F.A.
dc.date.accessioned2011-05-15T16:15:32Z
dc.date.available2011-05-15T16:15:32Z
dc.date.issued1997
dc.description.abstractWe reviewed 39 children < 15 years of age treated for Hodgkin's disease (HD) from 1973 to 1996. There were seven black, 12 white and 20 coloured children (of mixed ethnic origin). The M:F ratio was 2.9:1 and the median ages 147, 124 and 119 months in white, coloured and black children, respectively. Coloured and black children came mainly from a poor socio-economic background. Cervical lymphadenopathy was present in 74% and systemic symptoms in 51% of cases. Five per cent had clinical stage I, 41% stage II, 28% stage III and 26% stage IV disease. Two children underwent a staging splenectomy. The majority of white children presented with stages I and II and the majority of black and coloured children with stages III and IV HD. Nodular sclerosing (59%), mixed cellularity (40%) and lymphocyte-depleted (43%) were the most common histological subtypes in white, coloured and black children, respectively. Epidemiologically, white children fitted the criteria for HD type I and coloured and black children the criteria for HD type III. Nineteen children were treated with ChlVPP (chlorambucil, vinblastine, prednisone, procarbazine) and 20 with MOPP (mustine, Oncovin, procarbazine, prednisone) and/or ABVD (Adriamycin, bleomycin, vinblastine, DTIC) with involved field radiotherapy to bulky mediastinal disease. The projected 10-year survival after ChlVPP or MOPP/ABVD therapy was similar at 52%. In stages I and II, HD projected survival at 5 and 10 years was 85%, and in stages III and IV it was 82% at 5 and 48% at 10 years. The relapse rate was 47% in stage II, 45% in stage III and 44% in stage IV. Tuberculosis was suspected and treated in five children at the time of, and in seven children (three confirmed) subsequent to, the diagnosis of HD. Varicella developed in six and herpes zoster in five children. Five treatment-related deaths were due to septicaemia following splenectomy (two), marrow failure, cor pulmonale and secondary leukaemia.
dc.description.versionArticle
dc.identifier.citationAnnals of Tropical Paediatrics
dc.identifier.citation17
dc.identifier.citation4
dc.identifier.issn02724936
dc.identifier.urihttp://hdl.handle.net/10019.1/13382
dc.subjectbleomycin
dc.subjectchlorambucil
dc.subjectchlormethine
dc.subjectdacarbazine
dc.subjectdoxorubicin
dc.subjectprednisone
dc.subjectprocarbazine
dc.subjectvinblastine
dc.subjectvincristine sulfate
dc.subjectadolescent
dc.subjectage
dc.subjectarticle
dc.subjectbone marrow depression
dc.subjectcaucasian
dc.subjectchickenpox
dc.subjectchild
dc.subjectclinical article
dc.subjectcor pulmonale
dc.subjectdisease classification
dc.subjectethnic group
dc.subjectfemale
dc.subjectherpes zoster
dc.subjecthodgkin disease
dc.subjecthuman
dc.subjectleukemia
dc.subjectlymphadenopathy
dc.subjectmale
dc.subjectmediastinum disease
dc.subjectmorbidity
dc.subjectnegro
dc.subjectrecurrence risk
dc.subjectsepticemia
dc.subjectsex ratio
dc.subjectsocial class
dc.subjectsouth africa
dc.subjectsplenectomy
dc.subjectsurvival
dc.subjectsymptom
dc.subjecttreatment outcome
dc.subjecttuberculosis
dc.subjectAdolescent
dc.subjectAge Distribution
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectBleomycin
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectChlorambucil
dc.subjectDacarbazine
dc.subjectDoxorubicin
dc.subjectFemale
dc.subjectHodgkin Disease
dc.subjectHumans
dc.subjectMale
dc.subjectMechlorethamine
dc.subjectMorbidity
dc.subjectNeoplasm Staging
dc.subjectPrednisolone
dc.subjectPrednisone
dc.subjectProcarbazine
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.subjectSurvival Rate
dc.subjectTreatment Outcome
dc.subjectVinblastine
dc.subjectVincristine
dc.titleHodgkin's disease in children in Southern Africa: Epidemiological characteristics, morbidity and long-term outcome
dc.typeArticle
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