Citations 2
Patterns of presentation and outcomes in stage IV Hodgkin lymphoma: A report from the Children's Oncology Group ( COG ) AHOD1331
Casey, Dana L. , Renfro, Lindsay A., Wu, Yue , McCarten, Kathleen, Pei, Qinglin , Milgrom, Sarah A., Cho, Steve, Keller, Frank G., Punnett, Angela, Kelly, Kara M., Castellino, Sharon M., Hoppe, Bradford S , Casey, Dana L , McCarten, Kathleen M. , Belsky, Jennifer A. , Keller, Frank G. , Punnett, Angela , Hodgson, David , Hoppe, Bradford S. , Kelly, Kara M. , Castellino, Sharon M.
British Journal of Haematology | July 9, 2026 | Volume: No volume available | Issue: No issue available | Pages: No page available
Summary Outcomes for high‐risk 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‐nodal sites contributing to stage IV disease. On AHOD1331 (NCT02166463), patients aged 2–21 years with high‐risk cHL (stage IIB with bulk/IIIB/IVA/IVB) were randomized to 5 cycles of doxorubicin, bleomycin, vincristine, etoposide, prednisone and cyclophosphamide (ABVE‐PC) versus Bv‐AVEPC. Patients with stage IV disease, determined by protocol‐defined and centrally reviewed Positron Emission Tomography ‐ Computed Tomography (PET‐CT), were identified. Baseline characteristics and progression‐free 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 years) with stage IV disease were included. Of these patients, 173 (51%) received ABVE‐PC and 167 (49%) Bv‐AVEPC. PFS was highest with lung‐only involvement (4‐year PFS 88.6%) and lowest with bone marrow‐only involvement (4‐year PFS 71.9%). Compared to ABVE‐PC, Bv‐AVEPC improved PFS among all stage IV patients (hazard ratio [HR] 0.53, 90% confidence interval (CI) 0.33–0.85) and in the lung‐only and bone‐only subgroups. However, no PFS benefit was observed in those with bone marrow‐only involvement. Among paediatric patients with stage IV cHL, Bv‐AVEPC 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.
Historical outcomes for patients with stage IA NLPHL: Global NLPHL One Working Group retrospective analyses
Flerlage, Jamie E. , Eichenauer, Dennis A. , Fuchs, Michael, Hartmann, Sylvia , Eich, Hans Theodor, Savage, Kerry J. , Skinnider, Brian, Akhtar, Saad , Steiner, R., Milgrom, Sarah A., Vega, Francisco, Alomari, Mohammed , Zhang, Xiaoyin , Collins, Graham P., Advani, Ranjana H, Kumar, Priyadarshini , Wirth, Andrew, Tsang, Richard, Smith, SD, Hendrickson, Peter G. , Hopkins, David, McKay, Pamela, Ng, Andrea K. , Koenig, Julie L. , Sakthivel, Gukan, Baron, Jonathan A, Roberts, Kenneth B. , Gao, Sarah, Alkendi, Jalila , Rahbi, Nasser Al, Balogh, Alexander George, Ricardi, Umberto, Sridhar, Akshay, Torka, Pallawi , Specht, Lena , Silva, Ravi De , Shah, Nimish, Osborne, Wendy , Henry, Michael, Chang, Isabela , Halperin, Daniel, Miall, Fiona , Brady, J.L. , Mikhaeel, G., Brennan, Bernadette , Penn, Anthony, Reeves, Marie, Terezakis, Stephanie A, Pepa, R Della, Picardi, Marco, Kirova, Youlia, Fergusson, Paige, Hawkes, Eliza A. , Lee, Denise , Ku, Matthew , Hamad, Nada, Mutsando, Howard , Tedjaseputra, Aditya , Gilbertson, Michael, Marconi, Tamara , Viiala, Nicholas , Palese, Monica , Kelly, Kara M, Borchmann, P, Hoppe, Richard T. , Advani, Ranjana H. , Hopkins, David , Baron, Jonathan , Vega, Francisco , Kumar, Priyadarshini , Dickinson, Michael , Smith, Sonali M , McKay, Pamela , Koenig, Julie , Casulo, Carla , Al Kendi, Jalila , Levis, Mario , Torka, Pallawi , Specht, Lena , De Silva, Ravindu , Pickard, Keir , Smith, Christine M , Brady, Jessica , Senchenko, Maria Anatolevna , Volchkov, Egor Vasilevich , Hoppe, Bradford S , Hawkes, Eliza , Lee, Denise , Doo, Nicole Wong , Barraclough, Allison , Cheah, Chan Yoon , Salvaris, Ross , Ku, Matthew , Hamad, Nada , Tedjaseputra, Aditya , Shankar, Ananth , Maurer, Matthew , Natkunam, Yasodha , Hoppe, Richard T , Binkley, Michael Sargent , Savage, Kerry J , Advani, Ranjana H , Hopkins, David , Baron, Jonathan , Eichenauer, Dennis A , Flerlage, Jamie E , Fuchs, Michael, Eich, Hans Theodor, Hodgson, David C. , Skinnider, Brian, Rauf, M. Shahzad , Maghfoor, Irfan , Pinnix, Chelsea C. , Alomari, Mohammed, Collins, Graham P. , Dickinson, Michael , Tsang, Richard , Prica, Anca A. , Major, Ajay , Kelsey, Chris R. , Constine, Louis S , Casulo, Carla , Plastaras, John Peter , Balogh, Alexander G., Levis, Mario , Ricardi, Umberto , Sridhar, Akshay, Shah, Nimish , Pickard, Keir , Blazin, Lindsay , Henry, Michael, Smith, Christine M. , Hoppe, Bradford S. , Talaulikar, Dipti , Pepa, Roberta Della , Picardi, Marco , Kirova, Youlia , Northend, Michael , Doo, Nicole Wong , Barraclough, Allison , Opat, Stephen , Cheah, Chan Y. , Hamad, Nada , Gilbertson, Michael , Maurer, Matthew J. , Natkunam, Yasodha , Kelly, Kara M. , Borchmann, Peter , Binkley, Michael S.
Blood Advances | April 14, 2026 | Volume: 10 | Issue: 15 | Pages: 5338-5347
10.1182/bloodadvances.2026020012
Abstract We evaluated outcomes by management type for patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) in the Global NLPHL One Working Group retrospective database of 2243 patients with stages I to IV disease diagnosed from 1992 to 2021 at 38 international institutions. A total of 779 patients had stage IA disease with median age of 35 years (range, 3-89) and median follow-up of 6.1 years. The 6-year progression-free survival (PFS) and overall survival were 86.3% and 97.7%, respectively. Outcomes were analyzed for the 2 groups: complete resection and unresected disease. Patients with a complete resection and observation alone (n = 99) had a 6-year PFS of 65.5% vs 90.5% for those who received radiotherapy (RT) (n = 53). Patients with unresected disease (n = 627; 80.5%) had a 6-year PFS of 62.0% for rituximab alone (n = 31), 89.6% for RT alone (n = 325), 76.8% for ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) alone (n = 40), and 94.3% for ABVD plus RT (n = 130). A total of 127 patients relapsed (16.3%), of which 25 (19.7%) had transformation. Our analysis suggests the following: (1) RT improves the PFS in patients with completely resected disease; (2) rituximab or ABVD alone does not appear to achieve a durable response; and (3) chemotherapy was not observed to add additional PFS benefit when used in combination with RT. Thus, for stage IA NLPHL, RT alone is likely sufficient for definitive treatment.