Pediatric Hodgkin Lymphoma Overview in Albania during the Last Decade

Mirela Xhafa, Mirzana Kapllanaj, Denada Paja, Enkeleda Duka, Donjeta Bali, Anila Godo

For citation: Xhafa M, Kapllanaj M, Paja D, Duka E, Bali D, Good A. Pediatric Hodgkin Lymphoma Overview in Albania during the Last Decade. International Journal of Biomedicine. 2024;14(1):26-29. doi:10.21103/Article14(1)_OA2
Originally published March 1, 2024


Background: Hodgkin lymphoma (HL) is a rare malignancy characterized by a malignant proliferation of cells in the reticuloendothelial system, mainly lymph node, and the presence of Reed-Sternberg cells with a relatively good prognosis compared to other pediatric malignancies. This study aimed to produce epidemiologic and clinical data on HL for Albania, aiming for a better understanding of the disease presentation to diagnose it at an earlier stage with the result of a better outcome.
Methods and Results: This single-center, retrospective study performed in the Mother Theresa University Hospital Center (Tirana, Albania) analyzed epidemiological and clinical data of pediatric patients under 14 years of age diagnosed with HL during a 10-year study period from 2012 to 2022. During the last 10 years, 25 children (ages 0-14) were diagnosed with HL at UHC "Mother Theresa," Tirana. From the demographic data of our study, most patients (68%) were in the age group of 10-14. The male-to-female ratio was 2.12:1. The first clinical presentation was mainly because of lymphadenopathy in 92% of patients, with the presence of B symptoms in 68%.
In most cases, the CBC was not affected, yet 24% of patients had high platelets, and 12% had low RBCs, while WBCs increased in 16% of patients and decreased in 12%.  Lymphopenia and monocytosis were found in more than half of cases. Around 68% of patients had high levels of LDH and CRP. ESR and ALP were high in 64% of patients, Ferritin was high in 32%, and fibrinogen level was high in 28%.
According to the Ann Arbor system, most of our patients were at stage II (32%), followed closely by stage I (28%) and stage III (24%), and only 16% were at stage IV upon presentation.
The most common histopathologic type was nodular sclerosis classical HL, presented in 44% of cases.
Conclusion: HL is a relatively frequent pediatric malignancy in young adults, affecting mainly males, and is diagnosed at a relatively early stage in our country.

Pediatric Hodgkin lymphoma • lymph node • complete blood count • diagnosis
  1. Takahara T, Satou A, Tsuzuki T, Nakamura S. Hodgkin Lymphoma: Biology and Differential Diagnostic Problem. Diagnostics (Basel). 2022 Jun 20;12(6):1507. doi: 10.3390/diagnostics12061507. PMID: 35741318; PMCID: PMC9221773.
  2. Massini G, Siemer D, Hohaus S. EBV in Hodgkin Lymphoma. Mediterr J Hematol Infect Dis. 2009 Nov 24;1(2):e2009013. doi: 10.4084/MJHID.2009.013. PMID: 21416003; PMCID: PMC3033177.
  3. Mani H, Jaffe ES. Hodgkin lymphoma: an update on its biology with new insights into classification. Clin Lymphoma Myeloma. 2009 Jun;9(3):206-16. doi: 10.3816/CLM.2009.n.042. PMID: 19525189; PMCID: PMC2806063.
  4. Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med. 1998 Nov 19;339(21):1506-14. doi: 10.1056/NEJM199811193392104. PMID: 9819449.
  5. ASH-SAP. American Society of Hematology Self-Assessment Program, Seventh Edition. Edited by Adam Cuker, Jessica K. Altman, Aaron T. Gerds, Ted Wun. American Society of Hematology, 2019.
  6. Zhou L, Deng Y, Li N, Zheng Y, Tian T, Zhai Z, Yang S, Hao Q, Wu Y, Song D, Zhang D, Lyu J, Dai Z. Global, regional, and national burden of Hodgkin lymphoma from 1990 to 2017: estimates from the 2017 Global Burden of Disease study. J Hematol Oncol. 2019 Oct 22;12(1):107. doi: 10.1186/s13045-019-0799-1. PMID: 31640759; PMCID: PMC6805485.
  7. Shamoon RP, Ali MD, Shabila NP. Overview and outcome of Hodgkin's Lymphoma: Experience of a single developing country's oncology centre. PLoS One. 2018 Apr 12;13(4):e0195629. doi: 10.1371/journal.pone.0195629. PMID: 29649329; PMCID: PMC5896958.
  8. PDQ Pediatric Treatment Editorial Board. Childhood Hodgkin Lymphoma Treatment (PDQ®): Health Professional Version. 2023 Dec 18. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002–. PMID: 26389170
  9. Kaplama ME, Güneş AK, Erden B. Evaluation of the predictive role of neutrophil/lymphocyte ratio in the diagnosis of lymphoma in patients with asymptomatic and ısolated cervical lymphadenopathy. Braz J Otorhinolaryngol. 2021 Mar-Apr;87(2):210-216. doi: 10.1016/j.bjorl.2020.06.012. Epub 2020 Aug 1. PMID: 32798200; PMCID: PMC9422533.
  10. Siddiqui DE, Akbar HF, Sadiq H, Iftikhar N, Khan MR, Raza MR. Primary Hodgkin's Lymphoma of bone in 7-year-old- an exceptional case report of youngest child in literature. Cancer Treat Res Commun. 2021;29:100448. doi: 10.1016/j.ctarc.2021.100448. Epub 2021 Aug 19. PMID: 34488186.
  11. Kristinsson SY, Landgren O, Sjöberg J, Turesson I, Björkholm M, Goldin LR. Autoimmunity and risk for Hodgkin's lymphoma by subtype. Haematologica. 2009 Oct;94(10):1468-9. doi: 10.3324/haematol.2009.010512. PMID: 19794095; PMCID: PMC2754970.
  12. Tomlinson R, Yaxley J. Thrombotic thrombocytopenic purpura associated with Hodgkin lymphoma and non-Hodgkin lymphoma. Pathology. 2018 Dec;50(7):776-777. doi: 10.1016/j.pathol.2018.05.011. Epub 2018 Oct 9. PMID: 30314645.

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Received January 13, 2024.
Accepted February 21, 2024.
©2024 International Medical Research and Development Corporation.