First report on newly diagnosed Indian childhood Hodgkin lymphoma patients treated on a risk-stratified response-based collaborative protocol (InPOG-Hl-15-01)

Abstract

Background/Objectives: Childhood Hodgkin lymphoma (HL) when treated appropriately and completely, has an excellent prognosis. Such treatment is often within the framework of large multicentre multinational cooperative group studies. The aim of InPOG-HL-15-01 multicentre prospective study is to describe the epidemiology and outcomes of children with HL in India treated on a risk-stratified, response-based strategy. Design/Methods: ABVD chemotherapy was used in a risk-stratified fashion - early stage (Stage I, IIA) four cycles ABVD, advanced stage (Stage IIB, III, IV) six cycles. Response assessed after two cycles. Radiation reserved for bulky disease or suboptimal response to two cycles. Events were death, progression/relapse, secondary malignancy and abandonment of treatment. Target recruitment was 350 patients over three years with follow-up of five years. Results: Recruitment commenced in August 2015. 310 patients enrolled from 27 centres (0-47 patients per centre, median 4 patients). Median age 8 years and 85% male. 29% received antituberculosis treatment prior. HL subtype was mixed cellularity 51%, nodular sclerosis 41%, others 8%. 66%% patients were advanced stage (Stage distribution was 9% I, 36% II, 36% III, 18% IV with 50% B symptoms). 51% had bulky disease. Till date, there have been 15 events in the 256 patients who have had at least one response assesment done so far – deaths 4, progressive disease 4, relapse 3, abandonment of treatment 4. Conclusion: This study demonstrates the feasibility of conducting a prospective multicentre study in absence of formal funding in childhood cancer in India and provides valuable high quality epidemiological information on childhood HL. Ongoing follow-up will provide more mature data on outcomes and help guide future practice and research. Acknowledgements: Pritanjali Singh, Anupama Borker, Hari Sankaran, Vineeta Gupta Bahu, Shailesh Kanvinde, Nandini Hazarika, Arun Seshachalam, Biswajit Dubashi, Krishnakumar Rathnam, Sudha Sinha, Sunil Bhatt, Sirisha Siddaiahgiri, Priyakumari Thankamony, Soma De, Chepsy Philip, Sanjeev Digra, Deepa Trivedi, Parul Takkar Chugh, Ankit Taluja.