title: Hodgkin's lymphoma in adolescents treated with adult protocols: a report from the German Hodgkin study group.
abstract: PURPOSE The standard of care for adolescent patients with Hodgkin's lymphoma (HL) is undefined, particularly the choice between pediatric and adult protocols. Thus, we compared risk factors and outcome of adolescents and young adults treated within study protocols of the German Hodgkin Study Group (GHSG). PATIENTS AND METHODS Three thousand seven hundred eighty-five patients treated within the GHSG studies HD4 to HD9 were analyzed; 557 patients were adolescents age 15 to 20 years, and 3,228 patients were young adults age 21 to 45 years. Results Large mediastinal mass and involvement of three or more lymph node areas were more frequent in adolescents (P < .001). The incidence of other risk factors did not differ significantly between age groups. With a median observation time of 81 months for freedom from treatment failure (FFTF) and 85 months for overall survival (OS), log-rank test showed no significant differences between age groups regarding FFTF (P = .305) and a superior OS (P = .008) for adolescents. Six-year estimates for FFTF and OS were 80% and 94%, respectively, for adolescents and 80% and 91%, respectively, for young adults. After adjustment for other predictive factors, Cox regression analysis revealed age as a significant predictor for OS (P = .004), with a higher mortality risk for young adults. Secondary malignancies were more common in young adults (P = .037). CONCLUSION Outcome of adolescent and young adult patients treated within GHSG study protocols is comparable. These data suggest that adult treatment protocols exhibit a safe and effective treatment option for adolescent patients with HL. However, longer follow-up, including assessment of late toxicity, is necessary for final conclusions.
authors.affiliation: First Department of Internal Medicine, University Hospital of Cologne, Kerpener Str 62, 50924 Cologne, Germany.
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Eichenauer
authors.forename: Henning
authors.initials: H
authors.lastname: Bredenfeld
authors.forename: Heinz
authors.initials: H
authors.lastname: Haverkamp
authors.forename: Horst
authors.initials: H
authors.lastname: Müller
authors.forename: Jeremy
authors.initials: J
authors.lastname: Franklin
authors.forename: Michael
authors.initials: M
authors.lastname: Fuchs
authors.forename: Peter
authors.initials: P
authors.lastname: Borchmann
authors.forename: Hans-Konrad
authors.initials: HK
authors.lastname: Müller-Hermelink
authors.forename: Hans T
authors.initials: HT
authors.lastname: Eich
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017024:Chemotherapy, Adjuvant; D005260:Female; D005858:Germany; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult