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Stratification of treatment intensity in relapsed pediatric Hodgkin lymphoma

Authors

  • Paul D. Harker-Murray MD, PhD,

    Corresponding author
    1. Division of Pediatric Hematology and Oncology, Midwest Children's Cancer Center, Milwaukee, Wisconsin
    • Correspondence to: Paul Harker-Murray, Division of Pediatric/Hematology/Oncology/BMT, Midwest Children's Cancer Center, 8701 Watertown Plank Road, MFRC3018, Milwaukee, WI 53226.

      E-mail: pharker@mcw.edu

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  • Richard A. Drachtman MD,

    1. Division of Pediatric Hematology Oncology, Robert Wood Johnson Medical School, New Brunswick, New Jersey
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  • David C. Hodgson MD,

    1. Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario
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  • Allen Russell Chauvenet MD, PhD,

    1. Children's Oncology Group, West Virginia University, Charleston, West Virginia
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  • Kara M. Kelly MD,

    1. Division of Pediatric Oncology, Columbia University Medical Center, New York, New York
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  • Peter David Cole MD

    1. Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York
    2. Department of Pediatric Hematology/Oncology, The Children's Hospital, Bronx, New York
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  • Conflict of interest: Nothing to declare.

Abstract

Risk-adapted, response-based therapies for pediatric Hodgkin lymphoma have resulted in 5-year survival exceeding 90%. Although high-dose chemotherapy and autologous hematopoietic stem cell transplantation (AHSCT) are considered standard for most patients with relapsed or refractory Hodgkin lymphoma, a subset of children with low risk relapse do not require AHSCT for cure. Currently there are no widely accepted criteria defining who should receive standard dose chemotherapy and/or radiotherapy, nor is there a standardized treatment regimen. We propose a risk-stratified, response-based algorithm for children with relapsed or refractory Hodgkin lymphoma that is based on a critical appraisal of published outcomes and prognostic factors. Pediatr Blood Cancer 2014;61:579–586. © 2013 Wiley Periodicals, Inc.

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