Objectives: To investigate the clinicopathological characteristics and prognostic factors of pediatric Hodgkin lymphoma (HL).
Methods: A retrospective analysis was conducted on the clinical data of children with newly diagnosed HL from January 2011 to December 2023 at four hospitals: Fujian Medical University Union Hospital, Fujian Medical University Zhangzhou Hospital, First Affiliated Hospital of Xiamen University, and Fujian Children's Hospital. Patients were categorized into low-risk (R1), intermediate-risk (R2), and high-risk (R3) groups based on HL staging and pre-treatment risk factors. The patients received ABVD regimen or Chinese Pediatric HL-2013 regimen chemotherapy. Early treatment response and long-term efficacy were assessed, and prognostic factors were analyzed using the Cox proportional hazards regression model.
Results: The overall complete response (CR) rates after 2 and 4 cycles of chemotherapy were 42% and 68%, respectively. Compared with the ABVD regimen group, patients treated with the HL-2013 regimen in the R1 group showed significantly higher CR rates after both 2 and 4 cycles (P<0.05). However, no statistically significant differences in CR rates were observed between the two regimens in the R2 and R3 groups (P>0.05). The 5-year event-free survival (EFS) rate, overall survival rate, and freedom from treatment failure rate were 83%±4%, 97%±2%, and 88%±4%, respectively. Cox analysis indicated that the presence of a large tumor mass at diagnosis and failure to achieve CR after 4 cycles of chemotherapy were independent risk factors for lower EFS rates (P<0.05).
Conclusions: Pediatric HL generally has a favorable prognosis. The presence of a large tumor mass at diagnosis and failure to achieve CR after 4 cycles of chemotherapy indicate poor prognosis.
目的: 探讨儿童霍奇金淋巴瘤（Hodgkin lymphoma, HL）的临床病理特征及预后因素。方法: 回顾性分析2011年1月—2023年12月期间福建医科大学附属协和医院、福建医科大学附属漳州市医院、厦门大学附属第一医院及福建省儿童医院等4家医院初诊HL患儿临床资料。按HL分期及治疗前危险因素分为低危组（R1组）、中危组（R2组）和高危组（R3组）。按治疗方案不同，分为ABVD方案和中国儿童HL-2013方案化疗组。评估其早期治疗反应及远期疗效，并采用Cox比例风险回归模型分析预后因素。结果: 总体化疗2疗程及4疗程后完全反应（complete response, CR）率分别为42%、68%。与ABVD方案组比较，接受HL-2013方案的患儿中，R1组2疗程及4疗程CR率显著增高（P<0.05），但R2/R3组CR率差异无统计学意义（P>0.05）。患儿5年无事件生存（event-free survival, EFS）率、总生存率及无治疗失败生存率分别为83%±4%、97%±2%及88%±4%。Cox分析显示，初诊伴有巨大瘤灶、化疗4疗程后未达CR是较低EFS率的独立危险因素（P<0.05）。结论: 儿童HL总体预后良好。初诊伴有巨大瘤灶、化疗4疗程后未达CR提示预后不良。.
Keywords: Chemotherapy; Child; Hodgkin lymphoma; Prognostic analysis.