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تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
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Risk-adapted treatment of newly diagnosed Hodgkin lymphoma in children and adolescents

Risk-adapted treatment of newly diagnosed Hodgkin lymphoma in children and adolescents
Low risk disease*
Four cycles of VAMP (vinblastine, doxorubicin, methotrexate, prednisone) plus LD-IFRT administered after the second cycle of chemotherapy[1]
Four cycles of COPP (cyclophosphamide, vincristine, procarbazine, prednisone)/ABV (doxorubicin, bleomycin, vinblastine) plus LD-IFRT[2]
ABVE (doxorubicin, bleomycin, vincristine, etoposide), administered for two to four courses depending on response, followed by LD-IFRT[3]
OEPA (vincristine, etoposide, prednisone, doxorubicin; for males) or OPPA (vincristine, procarbazine, prednisone, doxorubicin; for females) followed by LD-IFRT, depending upon the initial response to chemotherapy[4,5]
Intermediate risk disease*
Six cycles of COPP/ABV plus LD-IFRT[2]
ABVE-PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide), administered for three to five courses depending upon response, followed by LD-IFRT[4]
Two cycles of OPPA (for males) or OEPA (for females), followed by two cycles of COPP (for females) or COPDAC (cyclophosphamide, vincristine, prednisone, dacarbazine, for males) plus LD-IFRT[4-6]
High risk disease*
ABVE-PC, administered for three to five courses depending upon response, followed by LD-IFRT[4]
Two cycles of OPPA (for males) or OEPA (for females), followed by two cycles of COPP (for females) or COPDAC (for males) plus LD-IFRT[4-6]
Two cycles of cytarabine/etoposide, COPP/ABV, and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) plus LD-IFRT[1]
Four cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) with subsequent therapy dependent upon response; rapid responders: four cycles of COPP/ABV without IFRT (for females) or two cycles ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) with IFRT (for males); slow responders: four additional cycles of BEACOPP plus IFRT[7]
This table provides examples of treatment regimens that have been successfully employed in children and adolescents with newly diagnosed Hodgkin lymphoma. A choice among these treatment options is largely based upon physician experience, cancer center preference, and expected toxicities. The determination of preferred therapy for an individual patient should involve a multidisciplinary approach from the time of diagnosis.
LD: low dose; IFRT: involved field radiation therapy.
* For definition refer to UpToDate topics on Hodgkin lymphoma in children and adolescents.
References:
  1. Donaldson SS, Link MP, Weinstein HJ, et al. Final results of a prospective clinical trial with VAMP and low-dose involved-field radiation for children with low-risk Hodgkin's disease. J Clin Oncol 2007; 25:332.
  2. Nachman JB, Sposto R, Herzog P, et al. Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin's disease who achieve a complete response to chemotherapy. J Clin Oncol 2002; 20:3765.
  3. Tebbi CK, Mendenhall N, London WB, et al. Treatment of stage I, IIA, IIIA1 pediatric Hodgkin disease with doxorubicin, bleomycin, vincristine and etoposide (DBVE) and radiation: a Pediatric Oncology Group (POG) study. Pediatr Blood Cancer 2006; 46:198.
  4. Friedman DL, Chen L, Wolden S, et al. Dose-intensive response-based chemotherapy and radiation therapy for children and adolescents with newly diagnosed intermediate-risk hodgkin lymphoma: a report from the Children's Oncology Group Study AHOD0031. J Clin Oncol 2014; 32:3651.
  5. Dörffel W, Rühl U, Lüders H, et al. Treatment of children and adolescents with Hodgkin lymphoma without radiotherapy for patients in complete remission after chemotherapy: Final results of the multinational trial GPOH-HD 95. J Clin Oncol 2013; 31:1562.
  6. Mauz-Körholz C, Hasenclever D, Dörffel W, et al. Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin's lymphoma: the GPOH-HD-2002 study. J Clin Oncol 2010; 28:3680.
  7. Kelly KM, Sposto R, Hutchinson R, et al. BEACOPP chemotherapy is a highly effective regimen in children and adolescents with high-risk Hodgkin lymphoma: a report from the Children's Oncology Group. Blood 2011; 117:2596.
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