Management of relapsed and refractory classical Hodgkin lymphoma in children and adolescents.
There are a number of options for salvage treatment in children and adolescents with relapsed and refractory classical Hodgkin Lymphoma. These include salvage with standard dose chemotherapy, high dose chemotherapy with autologous stem cell transplant, allogeneic stem cell transplant or other novel approach. Radiotherapy has an important role in the salvage of some patients as part of a combined modality approach. This review outlines these salvage approaches and discusses whether the evidence from paediatric studies justifies a risk-adapted approach to salvage for individual patients or whether all patients should receive consolidation with high dose chemotherapy and autologous stem cell transplantation, which is often described as standard salvage management in adults. The important prognostic factors and how these may be used to allocate patients to standard versus high dose chemotherapy regimens are discussed. The role of allogeneic transplantation, novel agents and late effects will also be discussed.
Children and Young People's Cancer Service, University College Hospital London, London, UK. stephen.daw@uclh.nhs.uk
Stephen
S
Daw
Rob
R
Wynn
Hamish
H
Wallace
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D007246:Infertility / Q000517:prevention & control; D008297:Male; D011379:Prognosis; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*