Evaluation of the management of Hodgkin’s disease in Blida, Algeria


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Messaoud Ayad1, Kahina Rabahi1, Kada Boualga1
1Centre Anti-Cancer, Blida, Algeria

Background

Considerable progress has been made in the management of Hodgkin's disease in order to improve treatment outcomes but also reduce long-term side effects. We present a retrospective study over a period from 1998 to 2009 during which patients with Hodgkin's disease have been supported. OurObjective isto evaluate outcome of our patients treated with conventional therapy.

Method

Patients were included after additional tests: lymph node excision biopsy for histology, chest X-ray, thoracic abdominal and pelvic computed tomography, bone marrow biopsy, inflammatory balance. The therapeutic approach consisted of chemotherapy combined or not with radiotherapy according to clinical stage.

Results

During this period, 372 patients were included, 178 men and 194 women (sex ratio 0.92), mean age 31.47 (men 34.77 years, women 28.17 years). The histological type was specified in 350 cases (94 %): type 1: 15 cases (4.2%), type 2: 222 cases (63.4%), type 3: 102 cases (29.1%), and type 4: 11 cases (3.1%). Classification: favorable stage I: 15 cases (4%), unfavorable stage I: 13 cases (3.5%), unfavorable stage II: 28 (7.5%), favorable stage II: 118 (31.7%), stage IIIA: 17 (4.5%), Stage IIIB: 80 (21.5%) stage IV 101 (27.1%). Chemotherapy regimens: 367 patients were treated: 277 (74.4%) patients were treated with ABVD protocol, 68 with cisplatine + ABVD, 22 with MOPP / ABV, radiotherapy was associated in 219 patients (58.8%). Among these patients, failure was observed in 52 cases (14 %) with 40 (77 %) in disseminated stages.

Evolution: 232 (62.3%) patients are still alive in Complete Response (CR) or Incomplete Response (IR) ; relapse: 32 patients (8.6%); deaths: 61 patients (16.4%), however 43 patients (11,6) were lost to CR or IR.

Complications: Pulmonary fibrosis: 16 patients the cause of recurrent chest infections, cardiac toxicity: 6 patients, endocrine disorders: 14 patients (hypothyroidism, early menopause, impotence), neuropathy : 9 patients, herpes zoster : 5 patients, ENT neoplasia : 2 patients, Myelodysplasia: 4 patients.

Conclusion

The adaptation of therapeutic indications stage prognosis will improve our results, especially in adverse localised stages and disseminated stages, which represent the majority of our patients. ASCT will represent a treatment of choice for these patients who relapse after initial chemotherapy or for those primary refractory to first chemotherapy.