Risk-Stratified and Response-Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience

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Publicat a:Advances in Hematology vol. 2025 (2025)
Autor principal: Veron, David
Altres autors: Streitenberger, Patricia, Matus, Mónica, Pedro Negri Aranguren, Costa, Alejandra, Morell, Daniela, Terrasa, Sergio, Castellanos, E Mauricio, de Alarcon, Pedro, Dibar, Eduardo, Makiya, Mónica
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022 |a 1687-9104 
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024 7 |a 10.1155/ah/5453729  |2 doi 
035 |a 3236022658 
045 2 |b d20250101  |b d20251231 
100 1 |a Veron, David  |u Hospital Universitario Austral Pilar, Buenos Aires Argentina 
245 1 |a Risk-Stratified and Response-Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience 
260 |b John Wiley & Sons, Inc.  |c 2025 
513 |a Journal Article 
520 3 |a Background: The international cooperation between GATLA and AHOPCA with the support of St. Jude led to the adoption of the OEPA/COPDAC as a strategy to improve outcomes in high risk (HR) patients with HL. This study also includes the ABVD regimen for intermediate risk (IR) and low risk (LR) patients.Methods: Patients were stratified by predefined risk assignment. HR was defined as a disease in stages II B, III B, and IV. Modality treatment: LR: ABVD × 4 ± IFRT (20 Gy); IR: ABVD × 6 ± IFRT (20 Gy); and HR: OEPA–COPDAC + IFRT (20/25 Gy). The staging and response were reviewed in a periodic discussion of presentation of cases in the group. Eligibility for radiotherapy: LR patients in partial response (PR) after 4 ABVD and IR patients in PR after 2 ABVD received IFRT. All HR patients received IFRT at 20 (complete response (CR)) or 25 Gy (PR) depending on the response achieved after the first two OEPA cycles.Results: From November 2012 to June 2022, 203 pediatric patients were enrolled. A total of 171 patients were eligible in this analysis. HR: 98 patients (57.3%), IR: 52 patients (30.4%), and LR: 21 patients (12.3%). More than half of the patients were in stages III and IV and more than half also presented B symptoms. The response evaluation was performed by PET/CT in 147/171 patients (86%). A total of 68/171 patients (40%) did not received radiotherapy. Radiotherapy was omitted in 95% of the LR patients and 70% of the IR patients. The 10-year OS was 95% (90.7–97.6) for the 171 patients and 93% (85.3–96.4) for HR patients. The 10-year EFS was 91% (85.2–94.2) for the 171 patients and 87.8% (79.5–92.9) for HR patients.Conclusion: The international cooperation made it possible to significantly improve the outcomes of patients with advance disease in Argentina compared with our previous experience (7-PHD-96: COPP–ABV × 6 + IFRT Bulky Disease or PR (20/25 Gy): 5yOS: 85%, 5yEFS: 67%), reduce the number of patients who required radiotherapy, and reproduce the European experience for HR patients in a totally different context. 
651 4 |a Argentina 
653 |a Patients 
653 |a Tomography 
653 |a Abdomen 
653 |a Lymphoma 
653 |a Radiation therapy 
653 |a Pediatrics 
653 |a Lymphatic system 
653 |a Chemotherapy 
653 |a Biopsy 
700 1 |a Streitenberger, Patricia  |u Hospital Italiano de Buenos Aires Buenos Aires Argentina 
700 1 |a Matus, Mónica  |u Grupo Argentino Para el Tratamiento de Leucemias Agudas GATLA Buenos Aires Argentina 
700 1 |a Pedro Negri Aranguren  |u Hospital Materno Infantil San Roque Paraná Entre Ríos, Argentina 
700 1 |a Costa, Alejandra  |u Hospital de Niños Sor María Ludovica La Plata Argentina 
700 1 |a Morell, Daniela  |u Hospital Infantil de Córdoba Córdoba Argentina 
700 1 |a Terrasa, Sergio  |u Departamento de Investigaciones Hospital Italiano de Buenos Aires Buenos Aires Argentina 
700 1 |a Castellanos, E Mauricio  |u AHOPCA Unidad Nacional Oncología Pediátrica Guatemala City Guatemala 
700 1 |a de Alarcon, Pedro  |u Department of Pediatrics University of Illinois College of Medicine Peoria Illinois, USA 
700 1 |a Dibar, Eduardo  |u Grupo Argentino Para el Tratamiento de Leucemias Agudas GATLA Buenos Aires Argentina 
700 1 |a Makiya, Mónica  |u Grupo Argentino Para el Tratamiento de Leucemias Agudas GATLA Buenos Aires Argentina 
773 0 |t Advances in Hematology  |g vol. 2025 (2025) 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/3236022658/abstract/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/3236022658/fulltext/embedded/6A8EOT78XXH2IG52?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/3236022658/fulltextPDF/embedded/6A8EOT78XXH2IG52?source=fedsrch