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Patients (Stage IIIB\/IVB) received two cycles of ABVE\u2010PC (doxorubicin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide). Rapid early responders [RER, no positron emission tomography (PET) activity above mediastinal blood pool] were consolidated with 2 cycles of ABVE\u2010PC. Slow early responders (SER) received 2 cycles of ifosfamide\/vinorelbine and 2 cycles of ABVE\u2010PC. Radiotherapy was administered to sites of initial bulk and\/or SER. By intent\u2010to\u2010treat analysis, 4\u2010year second event\u2010free survival (EFS; freedom from second relapse or malignancy) was 91\u00b79% [95% confidence interval (CI): 86\u00b71\u201395\u00b73%], below the projected baseline of 95% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b7038). Five\u2010year first EFS and overall survival (OS) rates are 79\u00b71% (95% CI: 71\u00b75\u201384\u00b78%) and 95% (95% CI: 88\u00b78\u201397\u00b78%). Eight of 11 SER patients with persistent PET positive lesions at the end of chemotherapy had clinical evidence of active disease (3 biopsy\u2010proven, 5 with progressive disease or later relapses). Although this response\u2010directed approach did not reach the ambitiously high pre\u2010specified target for second EFS, EFS and OS rates are comparable with results of recent trials despite the reduction in radiotherapy volumes from historical involved fields. Persistent PET at end of chemotherapy identifies a cohort at an especially high risk for relapse\/early progression.<\/jats:p>","DOI":"10.1111\/bjh.16014","type":"journal-article","created":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T09:48:17Z","timestamp":1560160097000},"page":"39-48","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":70,"title":["Response\u2010adapted therapy for the treatment of children with newly diagnosed high risk Hodgkin lymphoma (AHOD0831): a report from the Children\u2019s Oncology Group"],"prefix":"10.1111","volume":"187","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1473-3937","authenticated-orcid":false,"given":"Kara M.","family":"Kelly","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology, Roswell Park Comprehensive Cancer Center Department of Pediatrics University at Buffalo Jacobs School of Medicine and Biomedical Sciences Buffalo NY 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