Faculty Collaboration Database

Outcome of adolescents and young adults compared to children with Hodgkin lymphoma treated with response-based chemotherapy on pediatric protocols: A Children's Oncology Group report. Pediatr Blood Cancer 2017 Dec;64(12)

Date

06/15/2017

Pubmed ID

28612375

Pubmed Central ID

PMC5799083

DOI

10.1002/pbc.26681

Scopus ID

2-s2.0-85020674164 (requires institutional sign-in at Scopus site)   15 Citations

Abstract

PURPOSE: We evaluated the outcome of children (<15 years) versus that of adolescents and young adults (AYA; 15-≤ 21 years) treated for Hodgkin lymphoma (HL) in two Pediatric Oncology Group/Children's Oncology Group clinical trials, P9425 and P9426, that used dose-dense, response-based chemotherapy and reduced dose radiotherapy.

PATIENTS AND METHODS: Subjects 21 years or younger with HL were eligible for these studies. Subjects with low-risk (stages IA, IIA, and IIIA1) without large mediastinal adenopathy biopsy-proven HL, eligible for P9426, were treated with two to four 28-day cycles of doxorubicin, bleomycin, vincristine, and etoposide (ABVE) chemotherapy and 25.5 Gy of involved field radiotherapy. Subjects with intermediate-risk (stages IB, IIA, IIIA1 with large mediastinal adenopathy, and IIIA2) and high-risk (stages IIB, IIIB, and IV) biopsy-proven HL, eligible for P9425, were treated with three to five 21-day cycles of ABVE plus prednisone and cyclophosphamide (ABVE-PC) chemotherapy and 21 Gy of involved region radiotherapy. We compared the 5-year event-free survival (EFS), based on Kaplan-Meier product-limit method, of children versus that of AYA.

RESULTS: Four hundred seventy-one subjects were enrolled on P9425 and P9426 combined. Of these subjects, 203 were AYA, 104 with intermediate and high-risk HL, and 99 with low-risk HL. The 5-year EFS of children did not significantly differ from that of AYA (85.9 vs. 87.1%) with a median follow up of 7.7 years (P = 0.51).

CONCLUSION: Given the equivalent and excellent results of therapy, HL represents an opportunity for adult and pediatric cancer treatment collaborative groups to jointly design clinical trials targeted to AYA. These trials should focus on both treatment efficacy and the quality of life of AYA while receiving chemotherapy and in reduction of long-term side effects in the survivorship years.

Author List

Fernández KS, Schwartz CL, Chen L, Constine LS, Chauvenet A, de Alarcón PA

Author

Cindy L. Schwartz MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Child
Clinical Protocols
Female
Hodgkin Disease
Humans
Male
Young Adult