Format

Send to

Choose Destination
Pediatr Blood Cancer. 2018 Dec;65(12):e27375. doi: 10.1002/pbc.27375. Epub 2018 Sep 14.

Outcomes in intermediate-risk pediatric lymphocyte-predominant Hodgkin lymphoma: A report from the Children's Oncology Group.

Author information

1
Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York.
2
Children's Oncology Group Statistics & Data Center, University of Florida, Gainesville, Florida.
3
Children's Oncology Group Statistics and Data Center, Monrovia, California.
4
Department of Pediatrics, Hackensack University Medical Center, Hackensack, New Jersey.
5
Department of Pediatrics, Roswell Park Cancer Institute, Buffalo, New York.
6
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
7
Department of Pediatrics, Vanderbilt University, Nashville, Tennessee.

Abstract

PURPOSE:

Optimal management of patients with intermediate-risk lymphocyte-predominant Hodgkin lymphoma (LPHL) is unclear due to their small numbers in most clinical trials. Children's Oncology Group AHOD0031, a randomized phase III trial of pediatric patients with intermediate-risk Hodgkin lymphoma (HL), included patients with LPHL. We report the outcomes of these patients and present directions for future therapeutic strategies.

PROCEDURE:

Patients received two cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (ABVE-PC) followed by response evaluation. Slow early responders were randomized to two additional ABVE-PC cycles ± two dexamethasone, etoposide, cisplatin, and cytarabine cycles and all received involved field radiotherapy (IFRT). Rapid early responders (RERs) received two additional ABVE-PC cycles. RERs with complete response (CR) were randomized to IFRT or no further therapy. RERs without CR received IFRT.

RESULTS:

Ninety-six (5.6%) of 1711 patients on AHOD0031 had LPHL. Patients with LPHL were more likely to achieve RER (93.6% vs. 81.0%; P = 0.002) and CR (74.2% vs. 49.3%; P = 0.000005) following chemotherapy compared with patients with classical HL. Five-year event-free survival (EFS) was superior in patients with LPHL (92.2%) versus classical HL (83.5%) (P = 0.04), without difference in overall survival (OS). Among RERs with CR following chemotherapy (n = 33), there was no difference in EFS or OS between those randomized to receive or not receive IFRT.

CONCLUSION:

Children and adolescents with intermediate-risk LPHL represent ideal candidates for response-adapted therapy based on their favorable outcomes. The majority of patients treated with the ABVE-PC backbone achieve RER with CR status and can be treated successfully without IFRT.

KEYWORDS:

clinical trial; lymphocyte-predominant Hodgkin lymphoma; pediatrics

PMID:
30277639
PMCID:
PMC6192844
[Available on 2019-12-01]
DOI:
10.1002/pbc.27375
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center