Ardine Reedijk conducted the study together with pediatric oncologist Auke Beishuizen and epidemiologist Henrike Karim-Kos. The team used data from the Dutch Cancer Registry. The study, which was published in the British Journal of Haematology, showed that survival rates of adolescents (15-17 years) with Hodgkin lymphoma increased 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 rate is now 98 percent.
The incidence of Hodgkin lymphoma
The incidence (new diagnoses) of Hogdkin lymphoma has 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 developing a second cancer. This study showed that in 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 found that there is an evident improvement in the treatment of Hodgkin lymphoma in patients between 15 and 24 years old. The risk of dying declines with 3 to 6 percent annually. Whether the adolescents were treated on a pediatric oncology ward 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.