The prognostic value of biological markers in paediatric Hodgkin lymphoma

Publication date: January 2016
Source:European Journal of Cancer, Volume 52
Author(s): Piero Farruggia, Giuseppe Puccio, Alessandra Sala, Alessandra Todesco, Salvatore Buffardi, Alberto Garaventa, Gaetano Bottigliero, Maurizio Bianchi, Marco Zecca, Franco Locatelli, Andrea Pession, Marta Pillon, Claudio Favre, Salvatore D'Amico, Massimo Provenzi, Angela Trizzino, Giulio Andrea Zanazzo, Antonella Sau, Nicola Santoro, Giulio Murgia, Tommaso Casini, Maurizio Mascarin, Roberta Burnelli
BackgroundMany biological and inflammatory markers have been proposed as having a prognostic value at diagnosis of Hodgkin lymphoma (HL), but very few have been validated in paediatric patients. We explored the significance of these markers in a large population of 769 affected children.Patients and methodsBy using the database of patients enrolled in A.I.E.O.P. (Associazione Italiana di Emato-Oncologia Pediatrica) trial LH2004 for paediatric HL, we identified 769 consecutive patients treated with curative intent from 1st June 2004 to 1st April 2014 with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or hybrid COPP/ABV (cyclophosphamide, vincristine, prednisone, procarbazine, doxorubicin, bleomycin and vinblastine) regimens.ResultsOn multivariate analysis with categorical forms, the 5-year freedom from progression survival was significantly lower in patients with stage IV or elevated value of platelets, eosinophils and ferritin at diagnosis. Furthermore, stage IV and eosinophils seem to maintain their predictive value independently of interim (after IV cycles of chemotherapy) positron emission tomography.ConclusionUsing the combination of four simple markers such as stage IV and elevated levels of platelets, ferritin and eosinophils, it is possible to classify the patients into subgroups with very different outcomes.



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