title: Minimal Treatment of Low-Risk, Pediatric Lymphocyte-Predominant Hodgkin Lymphoma: A Report From the Children's Oncology Group.
abstract: Children's Oncology Group study AHOD03P1 was designed to determine whether excellent outcomes can be maintained for patients with low-risk, pediatric lymphocyte-predominant Hodgkin lymphoma (LPHL) with a strategy of resection alone or minimal chemotherapy.
  
  
  
  Patients with stage IA LPHL in a single node that was completely resected were observed without further therapy; recurrences were treated with three cycles of doxorubicin/vincristine/prednisone/cyclophosphamide (AV-PC). Patients with unresected stage IA or stage IIA LPHL were treated with three cycles of AV-PC. Patients with less than a complete response (CR) to AV-PC received 21-Gy involved-field radiation therapy (IFRT).
  
  
  
  A total of 183 eligible patients were enrolled; 178 were evaluable. Of these, 52 patients underwent complete resection of a single node. There were 13 relapses at a median of 11.5 months; 5-year event-free survival (EFS) was 77% (range, 62% to 87%). A total of 135 patients received AV-PC; 126 were treated at diagnosis and nine at relapse after surgery alone. Eleven patients receiving AV-PC had less than CR and received IFRT. Fourteen first events occurred among 135 patients (12 relapses and two second malignancies). Two relapses occurred in patients who had received IFRT. Five-year EFS was 88.8% (95% CI, 81.8% to 93.2%). Five-year EFS for the entire cohort was 85.5% (95% CI, 79.2% to 90.1%); overall survival was 100%.
  
  
  
  Some 75% of highly selected pediatric patients with LPHL may be spared chemotherapy after surgical resection alone. Pediatric LPHL has excellent EFS with chemotherapy that is less intensive than standard regimens; > 90% of patients can avoid radiation therapy. The salvage rate for the few relapses is high, with 100% survival overall.
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX. bappel@HackensackUMC.org.
authors.forename: Burton E
authors.initials: BE
authors.lastname: Appel
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Lu
authors.initials: L
authors.lastname: Chen
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Allen B
authors.initials: AB
authors.lastname: Buxton
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Hutchison
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: David C
authors.initials: DC
authors.lastname: Hodgson
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Peter F
authors.initials: PF
authors.lastname: Ehrlich
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Louis S
authors.initials: LS
authors.lastname: Constine
authors.affiliation: Burton E. Appel, Hackensack University Medical Center, Hackensack, NJ; Lu Chen and Allen B. Buxton, Children's Oncology Group, Monrovia, CA; Robert E. Hutchison, State University of New York Upstate Medical University, Syracuse; Louis S. Constine, University of Rochester, Rochester, NY; David C. Hodgson, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Peter F. Ehrlich, University of Michigan, Ann Arbor, MI; and Cindy L. Schwartz, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Schwartz
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006689:Hodgkin Disease / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male