Treatment of Newly Diagnosed and Relapsed Hodgkin Lymphoma in Children

Hodgkin lymphoma (HL) accounts for about 10% of all childhood cancers. Five-year survival rates with modern therapies are now approaching 90- 95% as a consequence of its significant sensitivity to both chemotherapy and radiation. The current challenge is to determine how much therapy is needed to improve survival and how to adapt treatment to the patient to prevent these long term toxicities. This challenge has resulted in the development of different strategies aimed at recognizing the optimal balance between preserving overall survival and avoidance of long-term treatment-related morbidity. Strategies in children could be quite different from those used for adults with HL. More defined risk stratification through imaging studies and biologic markers have been developped. Increased knowledge of the biology of HL have led to the introduction of targeted therapies in both the frontline and relapsed patients. Collaborative multicenter studies are required to develop new combination therapies for children with newly diagnosed and refractory HL.