Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S410 procarbazine, and prednisone), in which he had received 6 cycles. After 15 months, a visible progression of the disease is noticed by repeating the PET-CT scan, and it is proposed to repeat the lymph node biopsy, which results in HL mixed-cellularity and was positive for PD-L1, CD79a. According to a conciliar consultation, the patient is treated with anti-PD-1 antibodies pembrolizumab monotherapy every 21 days. So far, the patient has received two cycles, and we are monitoring the case. Conclusion: Data supports using pembrolizumab as monotherapy in cases of relapsed HL; nevertheless, in our case, we do not have a sustained response to the therapeutic impact to draw a firm judgment. Keywords: HL, relapsed, pembrolizumab, case HL-291 Pediatric Hodgkin Lymphoma: Experience of Hematology Department in Casablanca Ibtissam El Bejjaj MD, Nisrine Khoubila PhD, Hajar Maataoui-Belaabes MD, Siham Cherkaoui PhD, Meryem Qachouh PhD, Mohamed Rachid PhD, Mouna Lamchahab PhD, Abdellah Madani PhD 20th August 1953 Hospital, Casablanca, Morocco Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) are children’s third most prevalent group of cancers. Today, the 5-year OS rate is almost 100%. Patients <18 years diagnosed with HL at our department from January 2016-December 2023 were retrospectively analyzed. Workup included a thorough medical history, physical examination, standard blood tests, FDG-PET, and biopsy. HL was staged according to the Ann Arbor staging system and assessed following the Lugano classification. Forty-two patients with HL were treated at our center during the above period. The M/F ratio was 3.6, and the median age was 11 years [3-17yo]. The most frequent mode of revelation was the appearance of adenopathy in 83% of patients, followed by B signs (29%). Adenopathy’s main location was at the cervical level, with a rate of 79%. Adenopathies were mostly unilateral (69%). The median size of adenopathies was 3 cm [0.5 cm-15 cm]. Twenty-six percent of adenopathies were bulky. The sedimentation rate was requested in 66% of patients and was high in 23 (82%). Initial pet scan was performed in 27 patients (64%) and CT in 15 patients(35%), demonstrating localized LH (stage I-II) in 40% and advanced stage (III-IV) in 60%. Mediastinal enlargement was found in 5 patients (12%). The dominant histological type was sclero-84% followed by mixed cellularity (10%), rich in lymphocytes (5%), and Poppema in 1 case. Bone marrow was infiltrated in 3 patients. Our patients were classified into favorable (20%), intermediate (30%), and unfavorable (50%) groups. The most used therapeutic protocol was EuroNet-PHL (88%); ABVD was used in 4 patients and VAMP in 1 patient. Forty-seven of the patients were irradiated. Being progressive, 2 patients received 3 lines of treatment, and 2 patients 4 lines. One patient presented with Lyell’s syndrome following his treatment (BENDAGEV). Seventy-four percent of patients are in complete metabolic remission, 7% have died, 7% are progressive, 5% are on palliative treatment, and 7% are lost to follow-up. Fiveyear overall and disease-free survival rates were 76% and 80%, respectively. HL treatment innovations have increased survival rates in children by >90%. Contemporary research aims to increase cure rates while lowering long-term toxicity. Keywords: HL, pediatric, radiotherapy, toxicity HL-326 Disseminated Pediatric Hodgkin Lymphoma (HL): Concentric Study Within the Hematology Department at Ibn Rochd University Hospital Hajar Maataoui-Belabbes MD, Ibtissam Bejjaj MD, Amine Benmoussa PhD, Meryem Qachouh PhD, Mouna Lamchahab PhD, Siham Cherkaoui PhD, Mohamed Rachid PhD, Abdellah Madani PhD, Nisrine Khoubila PhD Department of Hematology and Pediatric Oncology, Hospital August 20th 1953, IBN ROCHD, Casablanca, Morocco Introduction: HL represents 7% of childhood cancers, with long-term survival > 90%. 30% of patients with advanced-stage disease experience relapse. Materials and Methods: Descriptive retrospective study was carried out in Hematology Department in Casablanca. From January 2016 to December 2021, 42 pediatric patients with newly diagnosed HL, including 25 patients (59.5%) with disseminated stage. Only the latter category was included in this study. Results: The median age was 11 years [3-16] with a sex-ratio M/F 1.5. The average consultation time was 8.2 months [1-48]. The most common symptomatology was the appearance of lymphadenopathy in 15 cases. Respiratory symptoms were reported in 2, fever (1), and abdominal pain (2). B signs were present in 8 cases. The location of lymphadenopathy was cervical (15), submandibular (4), axillary (3), inguinal (3), parasternal mass (1), including 8 cases with bilateral location and 8 bulky with 7 cervical. Splenomegaly was present in 5 cases. PET scan was performed only in 17 patients. The distribution of stages was: 15 III and 10 IV. Within stage IV, the involvement of bone marrow was detected in 3 cases. The histopathological subtype was: nodular sclerosis in 20 cases, mixed cellularity in 3, lymphocyte rich in 1, and nodular lymphocyte-predominant in one. 20 patients were classified as an unfavorable group. The protocol used in the first line was MDH 2004 in all patients. A patient died of febrile neutropenia after the first course. PET scan after 2 cycles showed complete remission (CR) in 12 cases, partial remission (PR) in 10, and progression in 2 cases. PET scan after 4 cycles showed CR in 17 cases, PR in 3, and progression in 4 cases. 11 patients received radiotherapy. At the end of treatment, 6 patients had a positive PET scan, of which 2 were lost in follow-up, one patient died of concomitant tuberculosis, and 3 refractory diseases after 3 lines of salvage chemotherapy (ICE, BGev, DHAOx, IGEV). The overall survival at 2 years was 76%. Conclusion: Treatment guidelines are based on risk. Brentuximab vedotin constitutes an intensification of therapy for patients at high risk for first relapse. Keywords: Hodgkin lymphoma, disseminated stage, chemotherapy, pediatric, PET scan
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