title: Relapsed or poorly responsive nodular lymphocyte predominant Hodgkin lymphoma in children and adolescents - a report from the United Kingdom's Children's Cancer and Leukaemia Study Group.
abstract: There is a paucity of data on the treatment outcome in children with relapsed or poorly responsive nodular lymphocyte predominant Hodgkin lymphoma (nLPHL). This retrospective report evaluates the treatment outcome in a national cohort of children with relapsed or poorly responsive nLPHL. A total of 37 patients, 22 with relapsed and 15 with poorly responding disease, are the subjects of this report. Of the 22 patients with relapsed nLPHL, 11 had relapsed after primary excision biopsy, 10 after chemotherapy and 1 after chemotherapy and involved field radiotherapy. The majority had localized disease at relapse. The median time to relapse was 8 months after chemotherapy and 11 months after excision biopsy. Seven of the 15 patients with poorly responding nLPHL had variant histology. Three patients with initial poor response did not receive any further treatment and have had no disease progression. Transformation to diffuse large B cell lymphoma, in addition to evolution from typical to variant nLPHL occurred in one patient each. Thirty-four patients have been successfully re-treated with second chemotherapy or radiotherapy. Multiple relapses were uncommon but treatable. Relapse or poorly responsive nLPHL is fully salvageable with either additional chemotherapy and or radiotherapy.
authors.affiliation: Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Ananth G
authors.initials: AG
authors.lastname: Shankar
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, University College London, London, UK.
authors.forename: Amy A
authors.initials: AA
authors.lastname: Kirkwood
authors.affiliation: Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Sarita
authors.initials: S
authors.lastname: Depani
authors.affiliation: Department of Paediatric and Adolescent Oncology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Bianchi
authors.affiliation: Cancer Research UK Clinical Trials Unit, School of Cancer Sciences, University of Birmingham, Birmingham, UK.
authors.forename: Janis
authors.initials: J
authors.lastname: Hayward
authors.affiliation: Department of Cellular Pathology, University College London Hospitals NHS Foundation Trust, London, UK.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Ramsay
authors.affiliation: Department of Paediatric Oncology and Haematology, Children's Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
authors.forename: Georgina W
authors.initials: GW
authors.lastname: Hall
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002471:Cell Transformation, Neoplastic; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016403:Lymphoma, Large B-Cell, Diffuse; D016609:Neoplasms, Second Primary; D011878:Radiotherapy / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents
keywords: chemotherapy; children; nLPHL; relapse; rituximab