{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:46:59Z","timestamp":1767649619015,"version":"3.41.2"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:00:00Z","timestamp":1701734400000},"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":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/objectives<\/jats:title><jats:p>High\u2010risk Hodgkin lymphoma (HRHL) in children is curable with combined modality therapy. The Association of Pediatric Hematology\u2010Oncology of Central America (AHOPCA) is a consortium of cancer centers from Central America. In 2004, AHOPCA implemented a guideline with a short course of chemotherapy (mStanfordV), strict diagnostics, and radiation guidelines, aimed at reducing abandonment and improving outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Newly diagnosed children less than 18\u00a0years of age with high\u2010risk HL (Ann Arbor stages: IIB, IIIB, IV) from AHOPCA centers were staged with chest radiography and ultrasound or computed tomography. Therapy was a modified Stanford V (mStanfordV), substituting cyclophosphamide for mechlorethamine and involved field radiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 219 patients with HRHL, 181 patients were eligible and evaluable; 146 (81%) were boys, 22% being less than 6\u00a0years; 43 were stage IIB, 84 IIIB, and 54 IV. Thirty\u2010one (17%) abandoned therapy, 28 (15%) progressed, 30 (17%) relapsed, and eight (4%) died of toxicity. Radiation guidelines were not followed. Five\u2010year abandonment\u2010sensitive event\u2010free survival and overall survival (AS\u2010EFS, AS\u2010OS\u00a0\u00b1\u00a0SE) for the cohort were 46%\u00a0\u00b1\u00a04% and 56%\u00a0\u00b1\u00a04%; 5\u2010year AS\u2010OS for stages IIB, IIIB, and IV was 76%\u00a0\u00b1\u00a07%, 59%\u00a0\u00b1\u00a07%, and 35%\u00a0\u00b1\u00a07% (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.0006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite instituting a short treatment guideline, it did not improve the abandonment rate (17%) and did not achieve the reported outcomes of Stanford V. The cyclophosphamide dose used to replace merchlorethamine was inadequate. Despite strict guidelines, the radiation therapy application was inaccurate. Weekly chemotherapy may have adversely affected abandonment of therapy by increasing the burden of travel time. Based on these results, AHOPCA established a new abandonment strategy and a new guideline.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.30792","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T04:55:36Z","timestamp":1701838536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Treatment of high\u2010risk Hodgkin lymphoma with a modified Stanford V regimen in the AHOPCA: Substituting chemotherapy agents and hampered outcomes"],"prefix":"10.1002","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0713-7651","authenticated-orcid":false,"given":"Sandra","family":"Luna\u2010Fineman","sequence":"first","affiliation":[{"name":"Hematology\/Oncology\/SCT, Department of Pediatrics University of Colorado Aurora Colorado USA"},{"name":"Unidad Nacional de Oncolog\u00eda Pedi\u00e1trica (UNOP) Guatemala Guatemala"},{"name":"Global Pediatric Medicine St Jude Children's Research Hospital Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauricio","family":"Castellanos","sequence":"additional","affiliation":[{"name":"Unidad Nacional de Oncolog\u00eda Pedi\u00e1trica (UNOP) Guatemala Guatemala"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika L.","family":"Metzger","sequence":"additional","affiliation":[{"name":"M\u00e9decins sans Fronti\u00e8res Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Fulgencio","family":"Baez","sequence":"additional","affiliation":[{"name":"Oncolog\u00eda Pedi\u00e1trica Hospital Manuel de Jes\u00fas Rivera \"La Mascota\" Managua Nicaragua"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armando","family":"Pe\u00f1a Hernandez","sequence":"additional","affiliation":[{"name":"Oncolog\u00eda Pedi\u00e1trica Hospital Escuela Universitario Materno Infantil Tegucigalpa Honduras"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Bonilla","sequence":"additional","affiliation":[{"name":"Global Pediatric Medicine St Jude Children's Research Hospital Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soad","family":"Fuentes\u2010Alabi","sequence":"additional","affiliation":[{"name":"Oncolog\u00eda Pedi\u00e1trica Hospital de Ni\u00f1os Benjam\u00edn Bloom, Centro M\u00e9dico \"Ay\u00fadame a Vivir\" San Salvador El 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