[Evaluation of 5-year results of the scheduled treatment of lymphogranulomatosis in children].

A total of 186 children and adolescents aged 2.5 to 16 years with Hodgkin's disease were placed under observation. According to the accepted classification (Ann Harbour, 1971) they were divided into two groups. Exploration laparatomy was applied in the first group of the patients (n-103) as the final diagnostic stage in order to verify the pathomorphological stage of the process. In the second group (n-83) the clinical stage of the disease was only appraised. The pathological foci beneath the diaphragm were discovered, however, with the aid of ultrasonic tomography of the abdominal cavity, scanning with gallium-67 citrate, and computer-aided tomography. The latter technique was employed in case of controversies in the interpretation of the foci of lesion with the aid of the first two diagnostic methods. It is concluded that in view of the high tempo of the so-called silent generalization and dissemination of Hodgkin's disease in children, this condition should be regarded in childhood as a potentially systemic process. With such an attitude towards Hodgkin's disease in children it is advisable to abandon exploration laparotomy with splenectomy depriving the patient of the massive depot of humoral (B cell) immunity and creating the danger of an aggressive course of intercurrent infections in splenectomized children affected with Hodgkin's disease. In the choice of the initial treatment which provides the basis for obtaining the highest effect, preference should be given to polychemotherapy. It is indicated in the presence of "biological activity" of the process, general symptoms, generalization and dissemination of the process (stages III and IV), and in the presence of multiple foci in stage II.(ABSTRACT TRUNCATED AT 250 WORDS)