Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy: Final Results of the Multinational Trial GPOH-HD95

Dörffel, W; Rühl, U; Lüders, H; Claviez, Alexander; Albrecht, Marion; Bökkerink, J.P.M.; Holte, Harald; Karlén, Jonas; Mann, Georg; Marciniak, Heinz; Niggli, Felix; Schmiegelow, Kjeld; Schwarze, E. W.; Pötter, Richard; Wickmann, L.; Schellong, G

doi:10.1200/jco.2012.45.3266

Cited by 127 publications

(98 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The differences in given treatment in Denmark and Sweden, despite using the same protocols, probably reflect differences in protocol adherence and emphasize the value of enrolling patients in controlled trials to achieve stringent treatment decisions. In the GPOH-95 study, Sweden enrolled more patients than Denmark [20] and in the GPOH-HD-2002 [10] Denmark did not enroll patients at all. Since these protocols had recommendations on radiotherapy in the majority of arms this might have contributed to the higher extent of irradiated patients in Sweden.…”

Section: Discussionmentioning

confidence: 99%

Hodgkin lymphoma in children, adolescents and young adults – a comparative study of clinical presentation and treatment outcome

et al. 2017

View full text Add to dashboard Cite

Background: Hodgkin lymphoma (HL) treatment protocols for children, adolescents and young adults traditionally differ, but the biological and clinical justification for this remains uncertain. Material and methods: We compared age-dependent clinical presentation and treatment and outcome for 1072 classical HL patients 0-24 years diagnosed in Denmark (1990Denmark ( -2010 and Sweden (1992Sweden ( -2009 in pediatric (n ¼ 315, Denmark <15 years, Sweden <18 years) or adult departments (n ¼ 757). Distribution of clinical characteristics was assessed with Pearson's chi 2 -test and Mantel-Haenszel trend test. The Kaplan-Meier method was used for survival analyses. Hazard ratios (HR) were used to compare the different treatment groups and calculated using Cox regression. Results: Children (0-9 years) less often presented with advanced disease than adolescents (10-17 years) and young adults (18-24 years) (stage IIB-IV: children 32% vs. adolescents 50%, and adults 55%; p < .005). No variation in overall survival (OS) was seen between pediatric and adult departments or by country. Danish pediatric patients received radiotherapy (36%) less frequently than Swedish pediatric patients (71%) (p < .0001). Ten-year event-free survival (EFS) was lower among Danish pediatric patients (0-14 years) (0.79; 95% confidence interval (CI) 0.70-0.86) than among Swedish pediatric patients (0-17 years) (0.88; 95% CI 0.83-0.92), HR (1.93; 95% CI 1.08-3.46). A similar pattern was seen between adult patients in the two countries: Denmark 10-year EFS 0.85 (95% CI 0.81-0.88), Sweden 0.88 (95% CI 0.84-0.91), adjusted HR 1.51 (95% CI 1.03-2.22). Conclusion: Adolescents and young adults shared similar clinical presentation suggesting a rationale of harmonized treatment for these groups. Both adult and pediatric protocols provided high OS with no significant difference between the departments. The less frequent use of radiotherapy in Danish pediatric patients corresponded to a lower EFS, but comparable OS in all groups confirmed effective rescue strategies for the relapsing patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Hodgkin lymphoma in children, adolescents and young adults – a comparative study of clinical presentation and treatment outcome

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Higher recurrence rates among patients who were in intermediate and advanced stages of HL in this study led, in turn, to a change in treatment in the next one (the GPOH-HD-Intervall study): radiotherapy was withheld only from patients who were both in complete remission and in the early stages of the disease (stages I-IIA) (6,7). Every 2 to 3 years, information was obtained about recurrences and late sequelae, at first from the treating institutions and later from the patients themselves with standardized questionnaires.…”

mentioning

confidence: 88%

Secondary Malignancies Following Treatment for Hodgkin’s Lymphoma in Childhood and Adolescence

Dörffel

Riepenhausenl²,

Lüders³

et al. 2015

Deutsches Ärzteblatt International

Self Cite

View full text Add to dashboard Cite

show abstract

“…There is difference in 5-years EFS for patients with unfavorable early stage, stage III and IV (80% ± 9%, 73.9% ± 9.3% and 50% ± 11.2% respectively) but it isn't significant (p = 0.1) which was like Hudson et al [6] but it is unlike Droffel et al and Schwartz et al [22] [30].…”

Section: A M Ali Et Al Journal Of Cancer Therapymentioning

confidence: 79%

Risk-Adapted, Combined-Modality Therapy for Unfavorable Pediatric Hodgkin Lymphom

Ali¹,

Mohamed²,

Ahmed³

et al. 2018

JCT

View full text Add to dashboard Cite

Background and Objectives: Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life, with long term follow up. We assess the impact of prognostic factors associated with local treatment failure of pediatric HL patients with unfavorable criteria treated with combined modality: Alternating ABVD (Doxorubicin, Bleomycin, Vinblastine and Decarbazine) and COEP (Cyclophosphamide, Oncovin, Etoposide and Prednisone) chemotherapy and response-based, involved-field radiation for newly diagnosed unfavorable pediatric HL patients, also will detect toxicities and long-term complications observed in the patients. Methods: This prospective study was carried out from January 2010 to January 2018, with a median follow up of 74 months (range 8 -103 months). 54 patients were eligible for this study stratified into two groups: intermediate risk (IR) and high-risk group (HR). Patients were treated with (4 -6 cycles) and (6 -8 cycles) respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved a partial response. Results: 27 patients were IR and 27 patients were HR. There were 16 treatment failures; 5 patients had progressive disease; and 11 patients had a relapse. 9 patients died from their disease progression. The 5-year overall survival (OS) and event-free survival (EFS) rates (±SE) were 81.8% ± 5.7% and 71.8% ± 6.2% respectively. Multivariate analysis revealed that the only independent factor for inferior OS was radiotherapy. Conclusion: Treatment results of unfavourable HL patients in our study are satisfactory for with IR group but not for HR group who needs intensification of therapy. Radiotherapy is considered as a cornerstone in the treatment of the patients with unfavourable

show abstract

Treatment of Children and Adolescents With Hodgkin Lymphoma Without Radiotherapy for Patients in Complete Remission After Chemotherapy: Final Results of the Multinational Trial GPOH-HD95

Abstract: RT can be omitted in early stage HL in so defined CR following this chemotherapy. RT with 20(-35) Gy proved to be sufficient in patients with incomplete remission following chemotherapy.

Cited by 127 publications

References 35 publications

Hodgkin lymphoma in children, adolescents and young adults – a comparative study of clinical presentation and treatment outcome

Hodgkin lymphoma in children, adolescents and young adults – a comparative study of clinical presentation and treatment outcome

Secondary Malignancies Following Treatment for Hodgkin’s Lymphoma in Childhood and Adolescence

Risk-Adapted, Combined-Modality Therapy for Unfavorable Pediatric Hodgkin Lymphom

Contact Info

Product

Resources

About