Efficacy and toxicity of multiagent chemotherapy and low-dose involved-field radiotherapy in children and adolescents with Hodgkin's disease.

Hudson, Melissa M.; Greenwald, Carol; Thompson, Elizabeth I.; Wilimas, Judith A.; Marina, Neyssa; Fairclough, Diane L.; Kauffman, William M.; Bozeman, Paula M.; Mackert, Paul W.; Abromowitch, Minnie; Jenkins, Jesse J.; Boulden, Thomas; Kun, Larry E.

doi:10.1200/jco.1993.11.1.100

Cited by 130 publications

(41 citation statements)

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“…All patients were given risk-adapted, response-based chemotherapy, and most received involved-field radiation, unless they had favorable-risk disease after January of 2000 and were in complete remission after 8 weeks of chemotherapy, as previously described. [12][13][14][15] The risk classification system differed somewhat between successive treatment protocols. …”

Section: Patients and Therapymentioning

confidence: 99%

Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin's lymphoma

Hines-Thomas¹,

Howard²,

Hudson³

et al. 2010

Haematologica

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BackgroundBone marrow biopsy is considered essential for the staging and risk-adapted treatment of Hodgkin's lymphoma with unfavorable risk features. We reviewed the cases of pediatric Hodgkin's lymphoma in our institution to determine the impact of bone marrow involvement on treatment, relapse, and survival. Design and MethodsWe reviewed the clinical characteristics and outcome of 383 patients treated for Hodgkin's lymphoma at St. Jude Children's Research Hospital between August 1990 and August 2008. The 5-year survival estimates for patients with and without bone marrow involvement were compared. ResultsOf 228 patients who had a bone marrow biopsy at diagnosis, 21 had bone marrow involvement. Bone marrow findings changed the disease stage in only seven patients (3.1%): from IB to IVB (n=1), from IIA (with bulky disease) to IVA (n=1), from IIB to IVB (n=1), and from IIIB to IVB (n=4). One patient's risk assignment changed from intermediate to unfavorable risk without his chemotherapy being altered. No statistically significant difference was observed between patients with stage IV Hodgkin's lymphoma who did (n=21) and did not (n=61) have bone marrow involvement in 5-year relapse-free survival (89.6± 7% versus 73.9±6.1%; P=0.25) or 5-year overall survival (95.2±8.2% versus 87.3±4.9%; P=0.82). ConclusionsAlthough bone marrow involvement changed the stage in 3.1% of pediatric Hodgkin's lymphoma patients, it did not change risk-adapted treatment or prognosis. We conclude that bone marrow biopsy need not be performed at diagnosis in patients who have unfavorable risk features, although this finding should be confirmed by larger prospective studies.Key words: bone marrow, risk features, Hodgkin's lymphoma. 's lymphoma. Haematologica 2010;95(10):1691-1696. doi:10.3324/haematol.2010 This is an open-access paper. © F e r r a t a S t o r t i F o u n d a t i o n Citation: Hines-Thomas MR, Howard SC, Hudson MM, Krasin MJ, Kaste SC, Shulkin BL, and Metzger ML. Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin's lymphoma

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Section: Patients and Therapymentioning

confidence: 99%

Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin's lymphoma

Hines-Thomas¹,

Howard²,

Hudson³

et al. 2010

Haematologica

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“…Among older patients with HL, it has been repeatedly demonstrated that the survival data in populationbased studies are poorer than those from clinical trials (Kennedy et al, 1985;Appleton et al, 1995;Clarke et al, 2001;Proctor et al, 2002;Jarrett et al, 2005). This effect is likely to be due, at least in part, to the exclusion of frailer elderly individuals from clinical NLPHD (n=7) cHL (n=48) NLPHD ( (Hudson et al, 1993(Hudson et al, , 2004Hutchinson et al, 1998;Friedmann et al, 2002). This may be another explanation of the differences between the present investigation and that of Yung co-workers; most of the patients in the latter study were registered at the time of recruitment to clinical trials.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, in some areas, patients are being treated on designated teenage cancer units either by paediatric or adult teams. It is unsurprising, therefore, that there are considerable variations in the therapeutic regimens used in the management of these patients; while some patients are treated using regimens primarily designed for children (Jenkin et al, 1982;Ekert et al, 1988;Hudson et al, 1993;Hunger et al, 1994;Shankar et al, 1997Shankar et al, , 1998Weiner et al, 1997;Hutchinson et al, 1998;Schellong et al, 1999;Landmann-Parker et al, 2000), others are managed using adulttype approaches (Proctor et al, 1991;Yung et al, 2004).…”

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confidence: 99%

Outcome of a risk-related therapeutic strategy used prospectively in a population-based study of Hodgkin's lymphoma in adolescents

et al. 2007

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The aim was to assess outcome in a population-based cohort of adolescents with Hodgkin's lymphoma (HL) diagnosed in the UK's northern region over a 10-year period. Among a population of 3.09 million, 55 of 676 patients (8%) diagnosed with HL were aged 13 -19. Seven had nodular lymphocyte-predominant HL, 48 classical HL (cHL). Of the latter, 36 were X16 years. Application of the Scottish and Newcastle Lymphoma Group (SNLG) prognostic index meant 21 patients were considered high risk (index X0.5). They received PVACEBOP multi-agent chemotherapy as primary therapy. Standard risk patients (SNLG index o0.5) were treated with standard ChlVPP or ABVD chemotherapy7radiotherapy. Scottish and Newcastle Lymphoma Group indexing is not valid for patients under 16. Twelve patients therefore received UKCCSG protocols (n ¼ 8), ABVD plus radiotherapy (n ¼ 2), or PVACEBOP (n ¼ 2). Forty-six patients with cHL (96%) achieved complete remission. Seven patients relapsed but all entered complete remission after salvage therapy. Five patients died: three of HL, one in an accident and one of disseminated varicella complicating cystic fibrosis. Five-and 10-year overall survival was 93 and 86%, respectively; disease-specific survival was 95 and 92%. The data suggest that older adolescents with high-risk HL require intensive protocols as primary therapy to secure optimal outcome.

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“…Radyoterapi yönünden de yıllar içinde çocukluk çağında yan etkilerin azaltılması amacı ile yapı-lan çalışmalarda kombine multiajan kemoterapi ile düşük doz tutulu alan ışınlamasının etkinliği gösterilmiş ve bazı olgularda verilmemesi günde-me gelmiştir. [27][28][29] …”

Section: çOcukluk çAğı Hodgkin Lenfoma Tedavisinin Tarihçesiunclassified

Treatment of Hodgkin’s lymphoma in children

Kebudi¹

2015

TJ Oncol

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With the advances in current diagnostics and treatment modalities the survival in children with Hodgkin's lymphoma have significantly increased. The aim of the treatment nowadays is administering the most effective and least toxic treatment. This has leaded to "risk adapted, response and gender modified" treatments. In this review, the treatment modalities and results used in Hodgkin's lymphoma in children within decades have been assessed.

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Efficacy and toxicity of multiagent chemotherapy and low-dose involved-field radiotherapy in children and adolescents with Hodgkin's disease.

Abstract: The results demonstrate excellent disease control for the COP/ABVD regimen, with acceptable toxicity.

Cited by 130 publications

References 35 publications

Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin's lymphoma

Utility of bone marrow biopsy at diagnosis in pediatric Hodgkin's lymphoma

Outcome of a risk-related therapeutic strategy used prospectively in a population-based study of Hodgkin's lymphoma in adolescents

Treatment of Hodgkin’s lymphoma in children

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