INDIAN PEDIATRICS VOLUME 33- JULY 1996 561 Original Articles CHEMOTHERAPY IN HODGKIN'S DISEASE P. Kusuma Kumari, V.G. Chellam, Jayaprakash Madhavan, K. Ratheesan, G. Rajasekharan Pillai, S. Rajeev Kumar and M. Krishnan Nair From the Departments ofPediatric Oncology, Pathology and Radiotherapy, Regional Cancer Center, Trivandrum 695 Oil and Department of Pathology, Medical College, Trivandrum. Reprint requests: Dr. P. Kusuma Kumari, Associate Professor and Chief of Pediatric Oncology Division, Regional Cancer Center, Trivandrum 695 Oil. Received for publication: May 24,1995; Accepted: February 23,1996 Objective: To assess the efficacy of primary chemotherapy in patients with clinically staged Hodgkin's disease. Design: Non randomized study. Setting: Pediatric Oncology Division of Regional Cancer Center. Subjects: Twenty nine children with Hodgkin's disease. Interventions: Chemotherapy was given to 21 patients whose parents agreed for the same. Sixteen children received COPP regimen and 5 received MOPP regimen. Results: Complete remission was achieved in 19 patients. The relapse free survival and overall survival in these patients were 76% and 86%, respectively at 5 years. There was no death related to chemotherapy toxicity. Conclusion: Combination chemotherapy is an effective modality of treatment for children with Hodgkin's disease. Key words: Hodgkin's disease, Chemotherapy. ROGNOSIS in children with Hodgkin's Disease (HD) has steadily improved over the last 3 decades to become an ideal model where one can achieve high cure rates. The use of multiagent chemotherapy and radiotherapy had markedly improved the relapse free survival (RFS) and overall survival for children with HD(1). In an effort to maximize survival and minimize treatment related complications, various methods for treating children with HD have been reported. Some investigators use involved field radiation (IF XRT) alone in early stages, while others have advocated the use of chemotherapy and low dose irradiation regardless of initial stage in order to avoid the risk of growth retardation and staging laparotomy. In order to eliminate the marked growth disturbance following extended field irradiation and to avoid staging laparotomy, we have taken a policy decision to treat all pediatric patients with chemotherapy after clinical staging. The present study reports the results of treatment with primary chemotherapy. Subjects and Methods All children up to 14 years of age are seen in the Pediatric Oncology Department after registration. Between January 1984 and December 1988, 29 children with histologically proven HD were seen in this Department for further evaluation and management. Staging was done only clinically. The pretreatment studies included a detailed patient history, and physical examination. Routine laboratory studies including a complete blood cell count with differential count, erythrocyte sedimentation rate, renal and liver function studies were obtained for all children before therapy. All patients had chest roentgenograms, ultrasonography of P