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Survival rate adolescents and young adults with Hodgkin lymphoma improved

The survival rate of adolescents and young adults with Hodgkin lymphoma are strongly improved over the last decennia. In children with the same disease the prognosis was already positive and this has been stable. A studied from the Princess Máxima Center for pediatric oncology and the Integral Dutch Cancer Center (IKNL) demonstrated these developments.

Ardine Reedijk conducted the study together with child oncologist Auke Beishuizen and epidemiologist Henrike Karim-Kos. The team used data from the Dutch Cancer Registry. The study, which was published in British Journal of Haematology, showed that survival rates of adolescents (15-17 years) with Hodgkin lymphoma increase from 84 percent in the early nineties to 96 percent in the period between 2010-2015. For young adults (18-21 years) the chances improved from 90 percent to 97 percent. Children (<18 years) with Hodgkin lymphoma already had a good prognosis and the survival rates is now 98 percent.

The incidence of Hodgkin lymphoma

The incidence (new diagnoses) of Hogdkin lymphomahas been increased in young adults since the nineties. This is in accordance with an overall increase in cancer diagnoses. The researchers do not have an explanation for this rise. Conceivable influences, such as modern diagnostic tools and a potential increase in the incidence of infections with Epstein-Barr or HIV do not seem to explain this development.

Treatment

Patients with Hodgkin lymphoma have relatively positive chances of survival, however, the given treatment may affect them later in life. Previous studies have shown long term effects, such as damage to the heart or the appearance of a second cancer. This study showed that in the recent years oncologists treat less with radiotherapy and choose to treat with chemotherapy exclusively. Adolescents between 15 and 17 years old are more often treated in a center for pediatric oncology.

Survival

The research state in the article that there is an evident improvement in the treatment of Hodgkin lymphoma in patients betwee 15 and 24 years old. The chance of decease declines with 3 to 6 percent annually. Whether the adolescents were treated on the division for pediatric oncology did not influence survival rates. It is however essential to pay attention to the late effects of the treatment.

Conclusion and future studies

The incidence of Hodgkin lymphoma in children has been stable since 1990. The prognosis for children (<14 years) is positive; 98 percent of the children are still alive five years after diagnosis. Nowadays, this holds also true for patients between 15 and 24; a group for which the chances of survival have strongly improved since the early nineties. This information is important to evaluate treatment strategies and may also be useful in informing patients and their parents about their prognosis.