title: Clinical outcome in children and adolescents with Hodgkin lymphoma after treatment with chemotherapy alone - the results of the United Kingdom HD3 national cohort trial.
abstract: OBJECTIVE
  To assess the efficacy of a standardised hybrid chemotherapy treatment programme for Hodgkin lymphoma (HL) in a national series of children and adolescents.
  
  
  METHODS
  The 381 assessable patients, treated between March 2000 and April 2005 in the United Kingdom Children's Cancer Study Group trial, were reviewed to evaluate overall survival (OS), disease free survival (DFS) and deaths. Protocol treatment for stages 2-4 offered a hybrid programme of ChlVbPP (chlorambucil, vinblastine, prednisolone, procarbazine) alternating with ABVcD (doxorubicin, bleomycin, vincristine, dacarbazine). Patients with stage I disease only were offered involved field radiation alone or hybrid chemotherapy.
  
  
  RESULTS
  With a median follow up of 5.1 years (range 0.5-8.4 years), the 5 years OS and DFS for all patients was 97% and 78%, respectively. By multivariate analysis, mediastinal and stage IV disease at presentation were the only factors that affected achieving a complete response. The 5-year DFS rate for patients with stage IV disease was 55% whilst patients with mediastinal disease had a 2-fold higher risk of an event.
  
  
  CONCLUSIONS
  This study demonstrated that multi-agent chemotherapy alone is insufficient treatment for patients with mediastinal and stage IV disease.
authors.affiliation: Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Trust, London, UK.
authors.forename: Ananth
authors.initials: A
authors.lastname: Shankar
authors.forename: Maria
authors.initials: M
authors.lastname: Visaduraki
authors.forename: Janis
authors.initials: J
authors.lastname: Hayward
authors.forename: Bruce
authors.initials: B
authors.lastname: Morland
authors.forename: Keith
authors.initials: K
authors.lastname: McCarthy
authors.forename: Martin
authors.initials: M
authors.lastname: Hewitt
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002699:Chlorambucil / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003606:Dacarbazine / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000009:adverse effects / Q000627:therapeutic use; D011344:Procarbazine / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome; D006113:United Kingdom; D014747:Vinblastine / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D001761:Bleomycin; D002699:Chlorambucil; D011344:Procarbazine; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D011239:Prednisolone