R. Burnelli1, G. Fiumana1, M. Pillon2, A. Sala3, S. Buffardi4, L. Vinti5, M. Zecca6, A. Garaventa7, R. Rondelli8, P. Muggeo9, M. Provenzi10, P. Farruggia11, F. Rossi12, E. Facchini8, M. Mascarin13, on behalf of the Italian Association of Pediatric Hematology and Oncology
1 University Hospital Sant‘Anna-Ferrara, 2 Clinic of Pediatric Hemato-Oncology, University of Padua, 3 Clinic of Pediatrics, S.Gerardo Hospital, Monza, 4 Pediatric Oncology Department-Santobono-Pausilipon Hospital, Napoli, 5 Pediatric Oncology Department-Bambino Gesu‘ Hospital, Rome, 6 Pediatric Hematology-Oncology, San Matteo Hospital, Pavia, 7 Oncology Unit, Istituto G.Gaslini, Genova, 8 Pediatric Oncology Hematology, S.Orsola-Malpighi Hospital Bologna, 9 Division of Pediatric Hematology Oncology, Bari, 10 Pediatric Onco-hematology, Ospedali Riuniti, Bergamo, 11 Pediatric Hematology Oncology Unit, ARNAS Ospedali Civico Di Cristina e Benfratelli, Palermo, 12 Pediatric Oncology Service, Università della Campania “Luigi Vanvitelli”, Napoli, 13 Radioterapia Pediatrica e Area Giovani, CRO Aviano (PN)
Background: With 64.6 cases/million/year reported, Hodgkin's Lymphoma (HL) covers one quarter of all cancers in adolescents (15–19 years) and gives Italy one of the highest incidence rate worldwide. AIEOP-MH96 and AIEOP-LH2004 represent the last two national protocols for HL, with 1904 patients treated between 1996–2017. Elderly pts present a worse prognosis, but little is known about the prognostic factor of age in pediatric population.
Objective: Aim of this study is to evaluate the outcome of adolescents (age ≥15 and < 18 yrs) in two AIEOP consecutive studies, and to compare it with the prognosis of younger patients.
Methods: We analyzed all treatment data from 42 Italian Clinical Centers applying the MH96 and the subsequent LH2004 protocol, and collected by AIEOP Operative Centre in Bologna. For each protocol we evaluated the 10-year overall Survival (OS), Event-free Survival (EFS) and Freedom from Progression (FFP) rates registered in adolescents and in younger patients.
Results: From February 1996 to May 2004 and from June 2004 to June 2017, 605 and 1299 patients were enrolled respectively into the MH96 and LH2004 protocols: 560 and 1179 pts were considered evaluable for this analysis. Adolescent HL pts account for 27,5% of our trial population: 16% (90 pts) of MH96 and 32,9% (388 pts) of LH2004. 49 M and 41 F with a median age of 15,9 yrs were the MH96 adolescents; 186 M and 202 F with a median age of 15.05 yrs the LH2004 ones. Among pts < 15yrs, 12.5% were younger than 7 yrs in MH96, while only 7% in LH2004 population. There are no significative differences in stage distribution and in bulky disease between the two trials. Outcome is reported in the following table; no significant difference was observed between adolescents and younger patients.
Conclusion: In our experience, the proportion of adolescents with HL registered in the last AIEOP protocol redoubled. Even in the <15 yrs group of patients the proportion of older children increased. No difference in OS, EFS and FFP was observed between the adolescents and younger patients, at least when a protocol for pediatric patients was utilized.