Current approaches in the management of low risk Hodgkin lymphoma in children and adolescents

Abstract

SummaryThe outcome for children and adolescents with low risk Hodgkin lymphoma (HL) is excellent, with event-free survival >85% and overall survival >95%. Historically, however, treatment has come at the cost of significant long-term toxicity from chemotherapy, radiation or a combination of these. Recent treatment strategies have focused on maintaining high event-free and overall survival while minimizing the use of therapy associated with late effects. The strategies used to achieve this vary greatly among paediatric cooperative groups and there is no one standard treatment for children with low risk HL. This review summaries recent clinical trials in paediatric low risk HL and addresses some of the important considerations when comparing trials, including differences in the definition of low risk HL, differences in outcome among histological subtypes and varying approaches to reduce or eliminate radiation therapy. Recommendations are provided for the treatment of children with low risk HL outside the setting of a clinical trial.

ABVD‐Based Therapy for Hodgkin Lymphoma in Children and Adolescents: Lessons Learnt in a Tertiary Care Oncology Center in a Developing Country

“…In fact, out of all the pediatric malignancies, HL is one such disease whose success has been consistently duplicated in the developing world [1][2][3][4][5]. The focus of contemporary trials in the developed countries has been aimed at reducing short-and long-term toxicities without compromising these excellent cure rates [6][7][8][9]. This attempt may be difficult in settings like ours where patients often choose a greater certainty of cure over the risk of late effects.…”

Lymphomas in childhood

“…Bu şekilde sağaltım oranı %90'dır (1,4,14) . Düşük risk grubu olgularından tek lenf düğümü tutulumlu Evre IA hastalığı olan nodüler lenfosit baskın tip HH olan olgularda, yalnızca cerrahinin yeterli olduğunu bildiren yayın vardır (15) . Orta risk grubunda çoğu merkez adjuvan RT'nin başarıyı arttırdığı gö-rüşündedir (4,14) .…”

“…Erken ve geç dönem sorunlar görülebilir (4,13) . Boy kısalığı, kardiyak ve pulmoner işlevlerde bozulma, tiroid patolojileri, kısırlık, ikincil kanserler, yaşam kalitesinin ve psikososyal işlevlerin bozulması önemli sorunlardır (1,4,13,15,16) . Hastaların yaşam oranlarını azaltmadan bu karmaşalardan koruyacak sağaltım protokolleri geliş-tirilmesine çalışılmaktadır (6,13,15,17,18) .…”

Effect of chemotherapy alone with adult chemotherapy regimens on prognosis of children and adolescents with Hodgkin's disease

“…Hodgkin's disease (HD) is a malignant tumor of the lymphohematopoietic system that commonly occurs in children and adolescents (1)(2). Approximately 90% of patients with HD achieve long-term survival after standard treatment.…”