Review

. 2020 Jan 10;4(1):e329.

doi: 10.1097/HS9.0000000000000329. eCollection 2020 Feb.

Risk and Response Adapted Treatment Guidelines for Managing First Relapsed and Refractory Classical Hodgkin Lymphoma in Children and Young People. Recommendations from the EuroNet Pediatric Hodgkin Lymphoma Group

Stephen Daw¹, Dirk Hasenclever², Maurizio Mascarin³, Ana Fernández-Teijeiro⁴, Walentyna Balwierz⁵, Auke Beishuizen⁶, Roberta Burnelli⁷, Michaela Cepelova⁸, Alexander Claviez⁹, Karin Dieckmann¹⁰, Judith Landman-Parker¹¹, Regine Kluge¹², Dieter Körholz¹³, Christine Mauz-Körholz¹³, William Hamish Wallace¹⁴, Thierry Leblanc¹⁵

Affiliations

¹ Children and Young People's Cancer Services, University College Hospital London, London, UK.
² Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.
³ AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy.
⁴ Unit of Pediatric Onco-Hematology, Hospital Universitario Virgen Macarena, Seville, Spain.
⁵ Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
⁶ Prinses Máxima Centrum voor Kinderoncologie, Utrecht, The Netherlands.
⁷ Section of Pediatrics, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
⁸ Department of Pediatric Hematology and Oncology, University Hospital Motol, Czech Republic.
⁹ University Hospital Schleswig Holstein, Department of Pediatric and Adolescent Medicine, Pediatric Hematology, Oncology and Stem Cell Transplantation, Kiel, Germany.
¹⁰ Department of Radiation Oncology, Medical University of Vienna, Vienna.
¹¹ Service d'Hématologie et d'Oncologie Pédiatrique, Hôpital Armand Trousseau, Paris.
¹² Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
¹³ Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, Gießen, Germany.
¹⁴ Department of Pediatrics, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
¹⁵ University of Edinburgh and Department of Pediatrics, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.

PMID: 32072145
PMCID: PMC7000476
DOI: 10.1097/HS9.0000000000000329

Review

Risk and Response Adapted Treatment Guidelines for Managing First Relapsed and Refractory Classical Hodgkin Lymphoma in Children and Young People. Recommendations from the EuroNet Pediatric Hodgkin Lymphoma Group

Stephen Daw et al. Hemasphere. 2020.

. 2020 Jan 10;4(1):e329.

doi: 10.1097/HS9.0000000000000329. eCollection 2020 Feb.

Authors

Affiliations

¹ Children and Young People's Cancer Services, University College Hospital London, London, UK.
² Institute of Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany.
³ AYA and Pediatric Radiotherapy Unit, Centro di Riferimento Oncologico, Aviano, Italy.
⁴ Unit of Pediatric Onco-Hematology, Hospital Universitario Virgen Macarena, Seville, Spain.
⁵ Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland.
⁶ Prinses Máxima Centrum voor Kinderoncologie, Utrecht, The Netherlands.
⁷ Section of Pediatrics, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy.
⁸ Department of Pediatric Hematology and Oncology, University Hospital Motol, Czech Republic.
⁹ University Hospital Schleswig Holstein, Department of Pediatric and Adolescent Medicine, Pediatric Hematology, Oncology and Stem Cell Transplantation, Kiel, Germany.
¹⁰ Department of Radiation Oncology, Medical University of Vienna, Vienna.
¹¹ Service d'Hématologie et d'Oncologie Pédiatrique, Hôpital Armand Trousseau, Paris.
¹² Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany.
¹³ Pädiatrische Hämatologie und Onkologie, Zentrum für Kinderheilkunde der Justus-Liebig-Universität Gießen, Gießen, Germany.
¹⁴ Department of Pediatrics, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.
¹⁵ University of Edinburgh and Department of Pediatrics, Royal Hospital for Sick Children, Edinburgh, Scotland, UK.

PMID: 32072145
PMCID: PMC7000476
DOI: 10.1097/HS9.0000000000000329

Abstract

The objective of this guideline is to aid clinicians in making individual salvage treatment plans for pediatric and adolescent patients with first relapse or refractory (R/R) classical Hodgkin lymphoma (cHL). While salvage with standard dose chemotherapy followed by high dose chemotherapy and autologous stem cell transplant is often considered the standard of care in adult practice, pediatric practice adopts a more individualized risk stratified and response adapted approach to salvage treatment with greater use of non-transplant salvage. Here, we present on behalf of the EuroNet Pediatric Hodgkin Lymphoma group, evidence and consensus-based guidelines for standardized diagnostic, prognostic and response procedures to allocate children and adolescents with R/R cHL to stratified salvage treatments.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

**Figure 1**
**Summary of Treatment strategies**. ASCT = autologous stem cell transplant, CMR = complete metabolic remission, DS = Deauville score, HDCT = high dose chemotherapy, IFRT = involved filed radiotherapy, SDCT = standard dose chemotherapy. ^∗see text for further discussion.

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Risk and Response Adapted Treatment Guidelines for Managing First Relapsed and Refractory Classical Hodgkin Lymphoma in Children and Young People. Recommendations from the EuroNet Pediatric Hodgkin Lymphoma Group

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Risk and Response Adapted Treatment Guidelines for Managing First Relapsed and Refractory Classical Hodgkin Lymphoma in Children and Young People. Recommendations from the EuroNet Pediatric Hodgkin Lymphoma Group

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