{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T13:51:10Z","timestamp":1792158670732,"version":"4.4.0"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA098543"],"award-info":[{"award-number":["U10CA098543"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180899"],"award-info":[{"award-number":["U10CA180899"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10CA180886"],"award-info":[{"award-number":["U10CA180886"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R50 CA285492\u201001"],"award-info":[{"award-number":["R50 CA285492\u201001"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Outcomes for high\u2010risk paediatric classic Hodgkin lymphoma (cHL) improved with the addition of brentuximab vedotin (Bv) to doxorubicin, vincristine, etoposide, prednisone and cyclophosphamide (AVEPC) chemotherapy. We evaluated the prognostic implications of distant extra\u2010nodal sites contributing to stage IV disease. On AHOD1331 (NCT02166463), patients aged 2\u201321\u2009years with high\u2010risk cHL (stage IIB with bulk\/IIIB\/IVA\/IVB) were randomized to 5\u2009cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide (ABVE\u2010PC) versus Bv\u2010AVEPC. Patients with stage IV disease, determined by protocol\u2010defined and centrally reviewed Positron Emission Tomography \u2010 Computed Tomography (PET\u2010CT), were identified. Baseline characteristics and progression\u2010free survival (PFS) were compared by pattern of stage IV involvement (lung, bone, bone marrow, multiple sites and others). A total of 340 patients (median age 15\u2009years) with stage IV disease were included. Of these patients, 173 (51%) received ABVE\u2010PC and 167 (49%) Bv\u2010AVEPC. PFS was highest with lung\u2010only involvement (4\u2010year PFS 88.6%) and lowest with bone marrow\u2010only involvement (4\u2010year PFS 71.9%). Compared to ABVE\u2010PC, Bv\u2010AVEPC improved PFS among all stage IV patients (hazard ratio [HR] 0.53, 90% confidence interval (CI) 0.33\u20130.85) and in the lung\u2010only and bone\u2010only subgroups. However, no PFS benefit was observed in those with bone marrow\u2010only involvement. Among paediatric patients with stage IV cHL, Bv\u2010AVEPC improved PFS across most patterns of stage IV disease, except in those with bone marrow involvement. These results will guide efforts to improve outcomes among children with stage IV cHL.<\/jats:p>","DOI":"10.1111\/bjh.70625","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:15:21Z","timestamp":1783556121000},"page":"1746-1753","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of presentation and outcomes in stage\n                    <scp>IV<\/scp>\n                    Hodgkin lymphoma: A report from the Children's Oncology Group (\n                    <scp>COG<\/scp>\n                    )\n                    <scp>AHOD1331<\/scp>\n                    trial"],"prefix":"10.1111","volume":"209","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6851-7653","authenticated-orcid":false,"given":"Dana L.","family":"Casey","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of North Carolina School of Medicine  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay A.","family":"Renfro","sequence":"additional","affiliation":[{"name":"Division of Biostatistics University of Southern California  Los Angeles California USA"},{"name":"Children's Oncology Group  Monrovia California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Children's Oncology Group Statistics and Data Center University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"McCarten","sequence":"additional","affiliation":[{"name":"Pediatric Radiology, Imaging and Radiation Oncology Core Rhode Island  Lincoln Rhode Island USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinglin","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Children's Oncology Group Statistics and Data Center University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah A.","family":"Milgrom","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Colorado  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Belsky","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Indiana University School of Medicine  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Radiology, Wisconsin Institutes for Medical Research University of Wisconsin  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank G.","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Punnett","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Hospital for Sick Children and University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Hodgson","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Princess Margaret Cancer Centre, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2312-5418","authenticated-orcid":false,"given":"Bradford S.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kara M.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Roswell Park Comprehensive Cancer Center University of Buffalo  Buffalo New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon M.","family":"Castellino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta  Atlanta Georgia 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