Early type I - pattern of Hodgkins disease in Turkish children (0-6 years of age)

A.O. ÇavdarMD a,b, S. Gözdasoglu MD a, G. Yavuz MD a, E. Ünal MD a, A. Pamir MD a, N. Taçyildiz MD a

Pediatric Hematology and Oncology Research Center of Ankara University a and Cancer Committee of Turkish Academy of Sciences b Ankara, TURKEY

The aim of the study is to analyze retrospectively clinicoepidemiologic characteristics in 180 patients with pediatric Hodgkin disease (HD). In addition EBV - related finding and trace elements (Zn, Cu, Se) analyses were performed in some patients. Methods: All patients were histologically diagnosed by surgical biopsy in our center between 1964-1995. EBV studies were first performed serologically by indirect immunofluorescence method in 51 patients with HD and EBV-LMP1 by immuno-histochemical technique in 19 patients respectively. Trace elements were analyzed in 75 patients by atomic absorption spectrophotometer. Results: Analysis of the 175 patients (under 6 years old) with HD revealed that nearly 30% of them (52 cases) were in the age group of 0-6 years. Interestingly, characteristics of developing country pattern, type I pattern: male predominence, advanced stage, high MC histologic subtype etc. was observed in this group and named "Early type I pattern of HD" in Turkish children. The great majority of the patients belonged to low socio-economic status (SES). Analysis of anti - EBV antibodies, particularly anti EBV-VCA revealed seropositivitly in 94% of the patients (control 77%). EBV-related LMP1 were positive in one patient in this age group and in 13 of the 18 patients with HD older than 6 years. Zn and Se deficiencies and high Cu level were found in the patients prior to treatment and it was thought to be contributory factors in immune deficiency associated with this lymphoma. We believe that poor nutrition and low SES are important factors, because of their adverse effects on the immune system. It has been accepted that low SES may be associated with a chronic immunosuppressive state which predisposes the patients to viral infections, including EBV, as well as to M. lymphomas. More profound immunodeficiency in T cells immunity in our pediatric patients with HD may be responsible for the "type I pattern". The use of vaccine against EBV virus may be considered in developing countries, to combat early EBV infection and its consequences.

For more information, contact

Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Chromosomal Aberrations.