jueves, 17 de diciembre de 2015

Childhood Hodgkin Lymphoma Treatment—Health Professional Version - National Cancer Institute

Childhood Hodgkin Lymphoma Treatment—Health Professional Version - National Cancer Institute

National Cancer Institute

Childhood Hodgkin Lymphoma Treatment–for health professionals (PDQ®)


Changes to This Summary (12/08/2015)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Added Gerber et al. as reference 16.
Added text to state that pediatric patients are more likely to have low-stage disease and no B symptoms or extranodal involvement than are adult patients.
Added text to state that pediatric patients have better outcomes than do adult patients, even when controlled for other prognostic factors.
Added text to state that the Children's Oncology Group (COG) AHOD1331 high-risk Hodgkin lymphoma initial therapeutics clinical trial uses fluorodeoxyglucose-positron emission tomography (PET) assessment graded by a 5-point visual scale or Deauville criteria after two chemotherapy cycles to define a rapid early-responding lesion for which radiation will be omitted. A mass of any size is permitted for a complete response designation if the PET is negative.
Added Table 3 about the Deauville scoring criteria.
Added Table 4 about the COG and Euronet definition of PET response of lymph node or nodal masses.
Added text to state that the intermediate-risk Hodgkin lymphoma study (AHOD0031) did not show a benefit for involved-field radiation therapy in patients who achieved a rapid and complete response to chemotherapy.
Added text to state that an analysis of patterns of failure among patients who relapsed on the AHOD0031 study demonstrated that first relapses more commonly occurred within the previously irradiated field and within initially involved sites of disease, including both bulky and nonbulky sites (cited Dharmarajan et al. as reference 50).
Revised text to state that ifosfamide and vinorelbine with or without bortezomib are agents used in the treatment of refractory or recurrent Hodgkin lymphoma (cited Horton et al. as reference 8 and level of evidence 2Div).
Revised text to state that a phase II trial in adults with Hodgkin lymphoma who relapsed after autologous stem cell transplantation (SCT) showed a complete remission rate of 34% and a partial remission rate of 40%. Added text to state that patients who achieved a complete remission had a 3-year progression-free survival rate of 58% and a 3-year overall survival rate of 73%, with only 6 of 34 patients proceeding to allogeneic SCT while in remission (cited Gopal et al. as reference 18).
Added text to state that the risk of ovarian failure after treatment with contemporary regimens using lower cumulative doses of cyclophosphamide without procarbazine is anticipated to be lower.
Added text to state that a German study demonstrated that parenthood for female survivors of Hodgkin lymphoma was similar to that of the general population, although parenthood was lower for survivors who received pelvic radiation therapy (cited Brämswig et al. as reference 16).
Added van Nimwegen et al. as reference 24.
Revised text to state that solid neoplasms most often involve the skin, breast, thyroid, gastrointestinal tract, lung, and head and neck, with risk increasing with radiation dose (cited Chowdhry et al. as reference 46).
This summary is written and maintained by the PDQ Pediatric Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ® - NCI's Comprehensive Cancer Database pages.

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