TAILIEUCHUNG - Prognostic Factors for Children With Hodgkin’s Disease Treated With Combined-Modality Therapy

Most mental health problems begin with early signs or identifiable risks. Even infants and toddlers in the first two years of life can experience risks or more serious conditions. Just over 20 percent of children (or 1 in 5) have either currently or at some point in their lives experienced a seriously debilitating mental disorder. 1 Child mental health disorders are not only very common but can also begin at a very young age. Children and youth with mental health problems have lower educational achievement, greater involvement with the criminal justice system and fewer stable and longer-term placements in. | Prognostic Factors for Children With Hodgkin s Disease Treated With Combined-Modality Therapy By Ron S. Smith Qing Chen Melissa M. Hudson Michael P. Link Larry Kun Howard Weinstein Amy Billett Karen J. Marcus Nancy J. Tarbell and Sarah S. Donaldson Purpose Evaluation of pretreatment factors to identify children at high risk for relapse after combined-modality therapy for Hodgkin s disease. Patients and Methods From 1990 to 2000 328 pediatric patients with clinical stage I to IV Hodgkin s disease were treated with chemotherapy and low-dose involved-field radiotherapy on prospective collaborative risk-adapted protocols at three institutions. Pretreatment factors were analyzed by univariate and multivariate analysis for prognostic significance for 5-year disease-free survival DFS and overall survival OS . Results With a median follow-up of 59 months range 8 to 125 months the 5-year DFS and OS for all patients were 83 and 93 respectively. Several factors were associated with inferior DFS and OS by univariate analysis. By multivariate analysis male sex stage IIB IIIB or IV disease bulky mediastinal disease WBC more than X 103 mm3 and CONTEMPORARY TREATMENT for children and adolescents with Hodgkin s disease often uses a combined-modality approach with multiagent chemotherapy and involved-field radiotherapy. This approach has yielded excellent results with long-term disease-free survival DFS of 85 to 100 in patients with early-stage disease and of more than 60 in those with more advanced Consequently the focus of current treatment protocols has been to reduce treatment-related sequelae while maintaining excellent survival rates in those with early-stage disease and to improve survival in patients with advanced-stage disease. To achieve these goals the intensity and duration of treatment would ideally be tailored according to pretreatment factors that are prognostic for outcome. Prognostic factors have been identified in adult patients with Hodgkin s .

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