Introduction
Hodgkin Lymphoma (HL) in children is treated via a number of separate
protocols in the low, intermediate and high risk
stratums.1,2 In adults with HL however, ABVD has been
considered the de-facto standard of care for several decades due to its
effectiveness and excellent toxicity profile.3,4 Late
effects including cardiotoxicity and reduced fertility remain a concern
although overall the late effects profile is
favorable.5–7 There is also evidence that
radiotherapy can be eliminated in the low risk stratum, which is an
attractive approach to reduce risk of organ toxicities and secondary
malignancies.8
In the pediatric patient population, ABVE-PC, a dose-dense regimen has
been more commonly used, especially in trials conducted by the
Children’s Oncology Group (COG). 1,2,9 ABVE-PC therapy
is often risk-adapted and based on interim disease
response.9,10 Given the ability of children to
tolerate more short-term toxicities, ABVE-PC is able to reduce exposure
to anthracyclines and alkylators.9 The COG study
AHOD0031 has also shown that external beam radiation treatment (XRT) can
be safely eliminated in patients with interim rapid early response
.9
An abstract presented findings comparing AYA patients in two different
clinical trials, and the results suggest that AYA patients do worse on
adult protocols (ABVD vs Stanford V) when compared to pediatric protocol
(ABVE-PC), with worse failure-free survival (FFS) and overall survival
(OS).11 We conducted a study to directly compare the
efficacy and toxicity of ABVD to ABVE-PC for patients with HL within
different disease risk strata. We hypothesized that ABVE-PC has a
similar outcome as measured by EFS and OS when compared to ABVD in
pediatric patients with newly diagnosed HL at our institution.