{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T07:42:50Z","timestamp":1784360570871,"version":"3.55.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,11,13]],"date-time":"2019-11-13T00:00:00Z","timestamp":1573603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Classical Hodgkin lymphoma (cHL) has excellent survival rates, but late effects are an issue and dictate modern approaches. We analyzed the clinical profile and outcome of cHL treated on a risk\u2010adapted approach aimed at reducing late effects while improving historical outcomes at our center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Children (\u226415 years) consecutively treated for cHL from January 2013 through December 2016 were retrospectively analyzed. <jats:sup>18<\/jats:sup>FDG\u2010PET\u2010CT\u2013based staging and response assessment was done after two cycles for early response (ERA) and end of chemotherapy (late\u2010response assessment [LRA]) if not in complete response (CR; Deauville\u00a0&lt;\u00a04) at ERA. Stages IA\/IB\/IIA were low risk (LR) and received two cycles of ABVD (adriamycin\/bleomycin\/vinblastine\/dacarbazine). Stages IAX\/IBX\/IIAX\/IIB\/IIIA were intermediate risk (IR), and stages IIBE\/IIBX\/IIIAE\/IIIAX\/IIIB\/IVA\/IVB were high risk (HR). Both received two cycles of OEPA (oncocristine\/etoposide\/prednisolone\/adriamycin). Those in ERA\u2010CR received two cycles of ABVD if LR, and two and four cycles of COPDac (cyclophosphamide\/oncocristine\/prednisolone\/dacarbazine), respectively, for IR and HR. Involved\u2010field radiotherapy (IFRT) was given to bulky sites and ERA\u00a0&lt;\u00a0CR. Those at LRA\u00a0&lt;\u00a0CR (Deauville\u00a0&lt;\u00a03) or progression at any stage received salvage regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study period, 126 patients were identified who received the above protocol. There were 12 LR, and 114 advanced staged Hodgkin lymphoma (AHL) (18, IR; 96, HR) of which 91 (79.8%) had bulky sites. Eight (66.6%) LR and 93 (83%) AHL patients achieved ERA\u2010CRs. IFRT was given to 4 (33.3%) LR patients with ERA\u00a0&lt;\u00a0CR, and 92 (80.7%) of AHL (91 bulky sites; 1 ERA\u00a0&lt;\u00a0CR). At a median follow\u2010up of 31 months (range, 17\u201362), three\u2010year event\u2010free survival (EFS) and overall survival (OS) were both 100% for LR, and 94.4% (95% CI, 66.0%\u201399.2%) for IR, whereas for HR it was 90.3% (95% CI, 82.2%\u201394.8%) and 92.6% (95% CI, 85.2%\u201396.4%), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Children with HL have favorable outcomes with manageable toxicities when treated on a risk\u2010stratified and adapted approach. A high proportion of AHL have bulky disease necessitating IFRT, a concern that will have to be factored in future strategies.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28058","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T05:30:18Z","timestamp":1573709418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical profile and outcome of classical Hodgkin lymphoma treated with a risk\u2010adapted approach in a tertiary cancer center in India"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6459-2058","authenticated-orcid":false,"given":"Badira Cheriyalinkal","family":"Parambil","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-295X","authenticated-orcid":false,"given":"Gaurav","family":"Narula","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0127-7987","authenticated-orcid":false,"given":"Maya","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sneha","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanuja","family":"Shet","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Epari","family":"Shridhar","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehal","family":"Khanna","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8558-4225","authenticated-orcid":false,"given":"Siddhartha","family":"Laskar","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumeet","family":"Gujral","sequence":"additional","affiliation":[{"name":"Department of Pathology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari","family":"Sankaran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shripad","family":"Banavali","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Tata Memorial Hospital  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28748"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.12.3736"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-3536(96)80030-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.3266"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.01.021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.11.059"},{"issue":"6","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1002\/mpo.2950170525","article-title":"Second malignant neoplasms following childhood Hodgkin's disease: treatment and splenectomy as risk factors","volume":"17","author":"Meadows AT","year":"1989","journal-title":"Med Pediatr Oncol"},{"key":"e_1_2_10_9_1","unstructured":"Euronet Hodgkin Lymphoma Protocol. Available at:https:\/\/www.skion.nl\/workspace\/uploads\/EuroNet-PHL-Interim-Treatment-Guidelines-2012-12-3v0-2.pdf. Accessed on 2 July 2018."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.52.5410"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-017-2304-6"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JGO.2016.005314"},{"key":"e_1_2_10_13_1","first-page":"1","article-title":"Can radiotherapy be omitted in children with Hodgkin lymphoma who achieve metabolic remission on interim positron emission tomography? Experience of a tertiary care cancer referral center","volume":"4","author":"Totadri S","year":"2018","journal-title":"J Glob Oncol"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.4103\/0019-509X.55546"},{"issue":"2","key":"e_1_2_10_15_1","first-page":"141","article-title":"Epidemiology of childhood Hodgkins disease: is it different in developing countries?","volume":"43","author":"Dinand V","year":"2006","journal-title":"Indian Pediatr"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e318271f587"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.32.15_suppl.e21000"},{"key":"e_1_2_10_18_1","unstructured":"PrasadM DhamankarV GoswamiS et\u00a0al.Late effects in long\u2010term survivors of childhood Hodgkin lymphoma: a single\u2010centre experience. 46th Congress of the International Society of Paediatric Oncology (SIOP) 2014.https:\/\/www.reasearchgate.net\/publication\/274953838_Late_Effects_in_Long_term_Survivors_of_Childhood_Hodgkin_Lymphoma_A_Single_Centre_Experience. Accessed April 18 2019."},{"key":"e_1_2_10_19_1","unstructured":"Landman\u2010ParkerJ WallaceWH HasencleverD et\u00a0al. First international inter\u2010group study for classical Hodgkin's lymphoma in children and adolescents: EuroNet\u2010PHL\u2010C1. Report of the latest Interim Analysis 10th International Symposium on Hodgkin Lymphoma; October 22\u201325 2016 Cologne Germany."}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28058","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.28058","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.28058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T23:30:45Z","timestamp":1694215845000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.28058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,13]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1002\/pbc.28058"],"URL":"https:\/\/doi.org\/10.1002\/pbc.28058","archive":["Portico"],"relation":{},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,13]]},"assertion":[{"value":"2019-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-10-03","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e28058"}}