title: A chemotherapy only therapeutic approach to pediatric Hodgkin lymphoma: AHOPCA LH 1999.
abstract: BACKGROUND
  AHOPCA is a collaborative group that designs uniform treatment regimens (protocols) for children diagnosed with cancer in Central America. Based on a preliminary report from one of the AHOPCA centers, AHOPCA adopted a treatment regimen to maintain a good event-free survival (EFS) as well as eliminate radiation therapy from the treatment of children with Hodgkin lymphoma.
  
  
  METHODS
  Newly diagnosed patients with histologically proven Hodgkin lymphoma were staged according to the Ann Arbor classification and divided into favorable (stage I, stage IIA, and IIIA) and unfavorable (stage IIB, IIIB, and IV) groups. Subjects classified as group 1 (favorable) were treated with six 28-day cycles of chemotherapy (COPP/COPP ± ABV). Subjects classified as group 2 (unfavorable) were treated with eight 28-day cycles of COPP/ABV chemotherapy.
  
  
  RESULTS
  Of 269 patients registered, 216 were eligible for evaluation. The mean age at diagnosis was 7.5 years with a male to female ratio of 3.7-1. The predominant histology was nodular sclerosis (44%) but with a relatively high proportion of mixed cellularity (35.2%) The EFS at 5 and 10 years was 71% and 68%, respectively. There was a 14% rate of abandonment of therapy.
  
  
  CONCLUSIONS
  This treatment regimen for children with Hodgkin lymphoma, when applied as a multi-institutional regimen, had poorer outcome than our previously reported preliminary data and was inferior to the EFS reported in high-income countries. The major contributor adversely affecting EFS in this report is abandonment of therapy. Given these results, AHOPCA initiated a concerted effort to decrease abandonment of therapy.
authors.affiliation: Unidad Nacional de Oncología Pediátrica, Guatemala, Guatemala.
authors.forename: E Mauricio
authors.initials: EM
authors.lastname: Castellanos
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Barrantes
authors.forename: L Fulgencio
authors.initials: LF
authors.lastname: Báez
authors.forename: Yessica
authors.initials: Y
authors.lastname: Gamboa
authors.forename: Armando
authors.initials: A
authors.lastname: Peña
authors.forename: Soad
authors.initials: S
authors.lastname: Alabi
authors.forename: Miguel
authors.initials: M
authors.lastname: Bonilla
authors.forename: Huaping
authors.initials: H
authors.lastname: Wang
authors.forename: Monika L
authors.initials: ML
authors.lastname: Metzger
authors.forename: Pedro A
authors.initials: PA
authors.lastname: de Alarcón
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D010352:Patient Dropouts; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D012074:Remission Induction; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D014747:Vinblastine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Hodgkin lymphoma; chemotherapy; radiation therapy