RESUMO
Aim of this study was to evaluate the long-term therapeutic outcome and treatment-related complications in Hodgkin disease. We reviewed the medical records of 93 patients diagnosed with classic Hodgkin lymphoma, treated, and followed-up during the last 25 years. The cohort study included 49 males and 44 females with median age 11.8 years old (range: 3.95 to 17.42 y). The most common subtype was nodular sclerosis in 47/93 (50.5%). B symptoms were present in 15/93 (16.1%). From January 2009 until December 2020, 55 (59%) patients diagnosed with Hodgkin lymphoma were treated according to European Network for Pediatric Hodgkin Lymphoma (EURONET)-PHL-C1 protocol. Concerning outcome, a total of 89/93 patients are alive. Relapse occurred in 7/93. Second malignancies are reported in a total of 5 patients, 3 solid tumors (thyroid cancer, breast cancer, and osteosarcoma), and 2 acute myeloid leukemias. The overall survival and event-free survival for the whole cohort were 95.7% and 83.9%, respectively. Disease-free survival was 92.5%. Although a considerable high fraction of patients with Hodgkin disease can achieve continuous complete remission, they are at a high risk of developing long-term treatment-related complications. High curative rates as well as prevention of late effects can be achieved by implementation of individualized treatment strategies and innovative treatments.
Assuntos
Doença de Hodgkin , Masculino , Feminino , Humanos , Criança , Adolescente , Doença de Hodgkin/terapia , Doença de Hodgkin/tratamento farmacológico , Seguimentos , Grécia/epidemiologia , Estudos de Coortes , Taxa de Sobrevida , Intervalo Livre de Doença , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêuticoAssuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Equinococose/diagnóstico , Equinococose/tratamento farmacológico , Pulmão/diagnóstico por imagem , Praziquantel/uso terapêutico , Criança , Quimioterapia Combinada , Duração da Terapia , Humanos , Imageamento por Ressonância Magnética , Masculino , Radiografia Torácica , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
We present the case of a 7-year-old boy who fulfilled the diagnostic criteria for hemophagocytic lymphohistiocytosis (HLH). Prompt visualization of his bone marrow confirmed the diagnosis of visceral leishmaniasis (VL). He responded well to treatment with liposomal amphotericin-B. The patient had a false-negative enzyme-linked immunosorbent assay for Leishmania infantum and a false-positive immunoglobulin M test for Epstein Barr virus (EBV). Because age at presentation is similar in children with VL and familial HLH for whom EBV is the usual trigger, ruling out VL is extremely important because nonspecific serologic tests for EBV can lead to the inappropriate diagnosis of EBV-driven primary HLH and to the administration of unnecessary immunochemotherapy.