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05-12-2014 | Pediatric lymphoma | Article

14. Pediatric Hodgkin Lymphoma

Authors: Georgina W. Hall, Cindy L. Schwartz, MD, MPH, Stephen Daw, Louis S. Constine, MD

Publisher: Springer International Publishing

Abstract

Pediatric/young adult HL is one of the few childhood malignancies that shares aspects of its biology and natural history with an adult cancer. Historically, children were thought to have a worse prognosis than adults due to antiquated treatment approaches that were initially designed to mitigate toxicities in children. It is now clear that effective therapy provides similar or even superior outcomes in children/young adults. A comparison of the demographics of clinical presentations of pediatric/adolescent HL compared with adult HL is presented in Table 14.1. The first of the bimodal incidence peaks in Hodgkin lymphoma (HL) occurs in teenagers and young adults (15–25-year age group). HL represents less than 5 % of malignancies in children under the age of 15 years. In contrast, it represents 16–20 % of malignancies in adolescents making it the most common malignancy of this age group.

Hochberg J, Waxman IM, Kelly KM et al (2009) Adolescent non-Hodgkin lymphoma and Hodgkin lymphoma: state of the science. Br J Haematol 144:24–40PubMedCrossRef

Foltz LM, Song KW, Connors JM (2006) Hodgkin’s lymphoma in adolescents. J Clin Oncol 24:2520–2526PubMedCrossRef

Donaldson SS, Kaplan HS (1982) Complications of treatment of Hodgkin’s disease in children. Cancer Treat Rep 66:977–989PubMed

Mauch PM, Weinstein H, Botnick L et al (1983) An evaluation of long-term survival and treatment complications in children with Hodgkin’s disease. Cancer 51:925–932PubMedCrossRef

Merchant TE, Nguyen L, Nguyen D et al (2004) Differential attenuation of clavicle growth after asymmetric mantle radiotherapy. Int J Radiat Oncol Biol Phys 59:556–561PubMedCrossRef

Probert JC, Parker BR, Kaplan HS (1973) Growth retardation in children after megavoltage irradiation of the spine. Cancer 32:634–639PubMedCrossRef

Donaldson SS, Glatstein E, Rosenberg SA, Kaplan HS (1976) Pediatric Hodgkin’s disease. II. Results of therapy. Cancer 37:2436–2447PubMedCrossRef

Constine LS, Donaldson SS, McDougall IR et al (1984) Thyroid dysfunction after radiotherapy in children with Hodgkin’s disease. Cancer 53:878–883PubMedCrossRef

Sklar C, Whitton J, Mertens A et al (2000) Abnormalities of the thyroid in survivors of Hodgkin’s disease: date from the childhood cancer survivor study. J Clin Endocrinol Metab 85:3227–3232PubMed

10.

Adams MJ, Hardenbergh PH, Constine LS et al (2003) Radiation-associated cardiovascular disease. Crit Rev Oncol Hematol 45:55–75PubMedCrossRef

11.

Hancock SL, Donaldson SS, Hoppe RT (1993) Cardiac disease following treatment of Hodgkin’s disease in children and adolescents. J Clin Oncol 11:1208–1215PubMed

12.

Kung FH, Schwartz CL, Ferree CR et al (2006) POG 8625: a randomized trial comparing chemotherapy with chemoradiotherapy for children and adolescents with Stages I, IIA, IIIA1 Hodgkin disease: a report from the Children’s Oncology Group. J Pediatr Hematol Oncol 28:362–368PubMedCrossRef

13.

Weiner M, Leventhal B, Brecher M et al (1997) Randomized study of intensive MOPP-ABVD with or without low-dose total nodal radiation therapy in the treatment of stages IIB, IIIA2, IIIB, and IV Hodgkin’s disease in pediatric patients: a Pediatric Oncology Group study. J Clin Oncol 15:2769–2779PubMed

14.

Schwartz CL, Constine LS, Villaluna D et al (2009) A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of P9425. Blood 114:2051–2059PubMedCentralPubMedCrossRef

15.

Diehl V, Franlin J, Pfreundschuh M et al (2003) Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med 348:2386–2399PubMedCrossRef

16.

Horning SJ, Hoppe RT, Breslin S et al (2002) Stanford V and radiotherapy for locally extensive and advanced Hodgkin’s disease: mature results of a prospective clinical trial. J Clin Oncol 20:630–637PubMedCrossRef

17.

Kaldor JM, Day NE, Clarke EA et al (1990) Leukemia following Hodgkin’s disease. N Engl J Med 322:7–13PubMedCrossRef

18.

Mackie E, Radford M, Shalet S (1996) Gonadal function following chemotherapy for childhood Hodgkin’s disease. Med Pediatr Oncol 27:74–78PubMedCrossRef

19.

Ortin TT, Shostak CA, Donaldson SS (1990) Gonadal status and reproductive function following treatment for Hodgkin’s disease in childhood: the Stanford experience. Int J Rad Oncol Biol Phys 19:873–880CrossRef

20.

van den Berg H, Furstner F, van den Bos C, Behrendt H (2004) Decreasing the number of MOPP courses reduces gonadal damage in survivors of childhood Hodgkin disease. Pediatr Blood Cancer 42:210–215PubMedCrossRef

21.

Canellos GP, Anderson JR, Propert KJ et al (1992) Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med 327:1478–1484PubMedCrossRef

22.

Hunger S, Link M, Donaldson S (1994) ABVD/MOPP and low-dose involved-field radiotherapy in pediatric Hodgkin’s disease: the Stanford experience. J Clin Oncol 12:2160–2166PubMed

23.

Bramswig J, Heimes U, Heiermann E et al (1990) The effects of different cumulative doses of chemotherapy on testicular function. Results in 75 patients treated for Hodgkin’s disease during childhood or adolescence. Cancer 65:1298–1302PubMedCrossRef

24.

Schellong G, Hornig I, Bramswig J et al (1988) Significance of procarbazine in the chemotherapy of Hodgkin’s disease-a report of the cooperative therapy study DAL-HD-85. Klin Padiatr 200:205–213PubMedCrossRef

25.

Bonadonna G, Santoro A (1982) ABVD chemotherapy in the treatment of Hodgkin’s disease. Cancer Treat Rev 9:21–35PubMedCrossRef

26.

Doerffel W, Luders H, Ruhl U et al (2003) Preliminary results of the multicenter trial GPOH-HD-95 for the treatment of Hodgkin’s disease in children and adolescents: analysis and outlook. Klin Padiatr 215:139–145CrossRef

27.

Landman-Parker J, Pacquement H, Leblanc T et al (2000) Localized childhood Hodgkin’s disease: response-adapted chemotherapy with etoposide, bleomycin, vinblastine, and prednisone before low-dose radiation therapy-results of the French Society of Pediatric Oncology Study MDH90. J Clin Oncol 18:1500–1507PubMed

28.

Donaldson S, Hudson M, Lamborn K et al (2002) VAMP and low-dose, involved-field radiation for children and adolescents with favorable, early-stage Hodgkin’s disease: results of a prospective clinical trial. J Clin Oncol 20:3081–3087PubMedCrossRef

29.

Tebbi CKMN, Schwartz C, Williams J et al (2001) Response dependent treatment of stages IA, IIA, and IIIA1 micro Hodgkin’s disease with ABVE and low dose involved field irradiation with or without dexrazoxane. Leuk Lymphoma 42:100

30.

Shahidi M, Kamangari N, Ashley S et al (2006) Site of relapse after chemotherapy alone for stage I and II Hodgkin’s disease. Radiother Oncol 78:1–5PubMedCrossRef

31.

Girinsky T, van der Maazen R, Specht L et al (2006) Involved-node radiotherapy (INRT) in patients with early Hodgkin lymphoma: concepts and guidelines. Radiother Oncol 79:270–277PubMedCrossRef

32.

Specht L, Yahalom J, Illidge T, Berthelsen AK, Constine LS, Eich HT, Girinsky T, Hoppe R, Mauch P, Mikhaeel G, Ng A (2013) Modern radiotherapy for Hodgkin lymphoma field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys 89:854–862

33.

Terezakis S, Metzger M, Hodgson D, Schwartz C, Advani R, Flowers C, Hoppe B, Ng A, Roberts K, Shapiro R, Wilder R, Yunes M, Constine L (2014) ACR appropriateness criteria: pediatric Hodgkin lymphoma. Ped Blood Cancer 61:1305–1312CrossRef

34.

Nachman JB Sposto R, Herzog P et al (2002) Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin’s disease who achieve a complete response to chemotherapy. J Clin Oncol 20:3765–3771CrossRef

35.

Wolden SL, Chen L, Kelly KM et al (2012) Long-term results of CCG 5942: a randomized comparison of chemotherapy with and without radiotherapy for children with Hodgkin’s lymphoma–a report from the Children’s Oncology Group. J Clin Oncol 30(26):3174–3180PubMedCentralPubMedCrossRef

36.

Korholz D, Claviez A, Hasenclever D et al (2004) The concept of the GPOH-HD 2003 therapy study for pediatric Hodgkin’s disease: evolution in the tradition of the DAL/GPOH studies. Klin Padiatr 216:150–156PubMedCrossRef

37.

Metzger ML, Weinstein HJ, Hudson MM, Billett AL, Larsen EC, Friedmann A, Howard SC, Donaldson SS, Krasin MJ, Kun LE, Marcus KJ, Yock TI, Tarbell N, Billups CA, Wu J, Link MP (2012) Association between radiotherapy vs no radiotherapy based on early response to VAMP chemotherapy and survival among children with favorable-risk Hodgkin lymphoma. JAMA 307(24):2609–2616PubMedCentralPubMedCrossRef

38.

Keller FG, Nachman J, Constine L et al (2010) A phase III study for the treatment of children and adolescents with newly diagnosed low risk Hodgkin lymphoma (HL) [abstract]. ASH Ann Meet Abstr 116:767

39.

Kelly KM, Hodgson D, Appel B et al (2013) Children’s Oncology Group’s 2013 blueprint for research: Hodgkin lymphoma. Pediatr Blood Cancer 60(6):972–978PubMedCrossRef

40.

Korholz D, Kluge R, Wickmann L et al (2003) Importance of F18- fluorodeoxy-D-2-glucose positron emission tomography (FDG-PET) for staging and therapy control of Hodgkin’s lymphoma in childhood and adolescence – consequences for the GPOH-HD 2003 protocol. Onkologie 26

41.

Weiner MA, Leventhal BG, Marcus R et al (1991) Intensive chemotherapy and low-dose radiotherapy for the treatment of advanced-stage Hodgkin’s disease in pediatric patients: a Pediatric Oncology Group study. J Clin Oncol 9:1591–1598PubMed

42.

Friedmann AM, Hudson MM, Weinstein HJ et al (2002) Treatment of unfavorable childhood Hodgkin’s disease with VEPA and low-dose, involved-field radiation. J Clin Oncol 20:3088–3094PubMedCrossRef

43.

Carde P, MacKintosh FR, Rosenberg SA (1983) A dose and time response analysis of the treatment of Hodgkin’s disease with MOPP chemotherapy. J Clin Oncol 1:146–153PubMed

44.

DeVita VT, Hubbard SM, Longo DL (1990) Treatment of Hodgkin’s disease. J Natl Cancer Inst Monogr 10:19–28

45.

van Rijswijk RE, Haanen C, Dekker AW et al (1989) Dose intensity of MOPP chemotherapy and survival in Hodgkin’s disease. J Clin Oncol 7:1776–1782PubMed

46.

Mauz-Körholz C, Hasenclever D, Dörffel W et al (2010) Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin’s lymphoma: the GPOH-HD-2002 study. J Clin Oncol 28(23):3680–3686PubMedCrossRef

47.

Dorffel W, Ruhl U, Luders H et al (2013) Treatment of children and adolescents with Hodgkin lymphoma without radiotherapy for patients in complete remission after chemotherapy: final results of the multinational trial GPOH-HD95. J Clin Oncol. doi:10.1200/JCO.2012.45.3266

48.

Kelly KM, Hutchinson RJ, Sposto R et al (2002) Feasibility of upfront dose-intensive chemotherapy in children with advanced-stage Hodgkin’s lymphoma: preliminary results from the Children’s Cancer Group Study CCG-59704. Ann Oncol 13(Suppl 1):107–111PubMedCrossRef

49.

Friedman DL, Wolden S, Constine DL et al (2010) AHOD0031: a phase III study of Dose-intensive therapy for intermediate risk Hodgkin lymphoma: a report from the children’s oncology group [abstract]. Blood 116:766

50.

Mason DY, Banks PM, Chan J et al (1994) Nodular lymphocyte predominance Hodgkin’s disease: a distinct clinico-pathological entity. Am J Surg Pathol 18:526–530PubMedCrossRef

51.

Diehl V, Sextro M, Franklin J et al (1999) Clinical presentation, course, and prognostic factors in lymphocyte-predominant Hodgkin’s disease and lymphocyte-rich classical Hodgkin’s disease: report from the European task force on lymphoma project on lymphocyte-predominant Hodgkin’s disease. J Clin Oncol 17:776–783PubMed

52.

Shankar A, Hall GW, Gorde-Grosjean S et al (2012) Treatment outcome after low intensity chemotherapy [CVP] in children and adolescents with early stage nodular lymphocyte predominant Hodgkin’s lymphoma – an Anglo-French collaborative report. Eur J Cancer 48:1700–1706PubMedCrossRef

53.

Sandoval C, Venkateswaran L, Billups C et al (2002) Lymphocyte-predominant Hodgkin disease in children. J Pediatr Hematol Oncol 24:269–273PubMedCrossRef

54.

Mauz-Korholz C, Gorde-Grosjean S, Hasenclever D et al (2007) Resection alone in 58 children with limited stage, lymphocyte-predominant Hodgkin lymphoma-experience from the European network group on pediatric Hodgkin lymphoma. Cancer 110:179–185PubMedCrossRef

55.

Appel B, Ehrlich P, Chen L et al (2012) Treatment of pediatric stage IA lymphocyte-predominant Hodgkin lymphoma with surgical resection alone: A report from the Children’s Oncology Group. American Society of Clinical Oncology Annual Meeting, Chicago, IL J Clin Oncol 30 (suppl abstr 9524).

56.

Murphy SB, Morgan ER, Katzenstein HM et al (2003) Results of little or no treatment for lymphocyte-predominant Hodgkin disease in children and adolescents. J Pediatr Hematol Oncol 25:684–687PubMedCrossRef

57.

Pellogrino B, Terrier-Lacobe MJ, Oberlin O et al (2003) Lymphocyte-predominant Hodgkin’s lymphoma in children: therapeutic abstention after initial lymph node resection – a study of the French Society of Pediatric oncology. J Clin Oncol 21:2984–2992

58.

Hall GW, Katzilakis N, Pinkerton CR et al (2007) Outcome of children with nodular lymphocyte predominant Hodgkin lymphoma – a Children’s Cancer and Leukaemia Group report. Br J Haematol 138:761–768PubMedCrossRef

59.

Biasoli I, Stamatoullas A, Meignin V et al (2010) Nodular, lymphocyte-predominant Hodgkin lymphoma: a long-term study and analysis of transformation to diffuse large B-cell lymphoma in a cohort of 164 patients from the Adult Lymphoma Study Group. Cancer 116:631–639PubMedCrossRef

60.

Wickert RS, Weisenburger DD, Tierens A et al (1995) Clonal relationship between lymphocytic predominance Hodgkin’s disease and concurrent or subsequent large-cell lymphoma of B lineage. Blood 86:2312–2320PubMed

61.

Advani RH, Horning SJ, Hoppe RT et al (2014) Mature results of a phase II study of Rituximab therapy for nodular lymphocyte-predominant Hodgkin lymphoma. J Clin Oncol 32:1200CrossRef

62.

Bhatia S, Robison LL, Francisco L et al (2005) Late mortality in survivors of autologous hematopoietic-cell transplantation: report from the bone marrow transplant survivor Study. Blood 105:4215–4222PubMedCentralPubMedCrossRef

63.

Baker KS, Gordon BG, Grass TG et al (1999) Autologous hemato-poetic stem-cell transplantation for relapsed or refractory Hodgkin’s disease in children and adolescents. J Clin Oncol 17:825–831PubMed

64.

Claviez A, Sureda A, Schmitz N (2008) Haematopoietic SCT for children and adolescents with relapsed and refractory Hodgkin’s lymphoma. Bone Marrow Transplant 42(Suppl 2):S16–S24PubMedCrossRef

65.

Lieskovsky YE, Donaldson SS, Torres MA et al (2004) High-dose therapy and autologous hematopoietic stem-cell transplantation for recurrent or refractory pediatric Hodgkin’s disease: results and prognostic indices. J Clin Oncol 22:4532–4540PubMedCrossRef

66.

Akhtar S, El Weshi A, Rahal M et al (2010) High-dose chemotherapy and autologous stem cell transplant in adolescent patients with relapsed or refractory Hodgkin’s lymphoma. Bone Marrow Transplant 45(3):476–482. Epub 2009 Sept 7PubMedCrossRef

67.

Williams CD, Goldstone AH, Pearce R et al (1993) Autologous bone marrow transplantation for pediatric Hodgkin’s disease: a case-matched comparison with adult patients by the European Bone Marrow Transplant Group Lymphoma Registry. J Clin Oncol 11:2243–2249PubMed

68.

Schellong G, Dorffel W, Claviez A et al (2005) Salvage therapy of progressive and recurrent Hodgkin’s disease: results from a multicenter study of the pediatric DAL/GPOH-HD study group. J Clin Oncol 23:6181–6189PubMedCrossRef

69.

Gorde-Grosjean S, Oberlin O, Leblanc T et al (2012) Outcome of children and adolescents with recurrent/refractory classical Hodgkin lymphoma, a study from the Société Française de Lutte contre le Cancer des Enfants et des Adolescents (SFCE). Br J Haematol 158(5):649–656PubMedCrossRef

70.

Chen AR, Hutchison R, Hess A et al (2007) Clinical outcomes of patients with recurrent/refractory Hodgkin disease receiving cyclosporine, interferon-V and interleukin-2 immunotherapy to induce autoreactivity after autologous stem cell transplantation with BEAM: a COG study. Blood;110:Abstract 1896

71.

Frankovich J, Donaldson SS, Lee Y et al (2001) High-dose therapy and autologous hematopoietic cell transplantation in children with primary refractory and relapsed Hodgkin’s disease: atopy predicts idiopathic diffuse lung injury syndromes. Biol Blood Marrow Transplant 7:49–57PubMedCrossRef

72.

Stoneham S, Ashley S, Pinkerton CR et al (2004) Outcome after autologous hemopoietic stem cell transplantation in relapsed or refractory childhood Hodgkin disease. J Pediatr Hematol Oncol 26:740–745PubMedCrossRef

73.

Bradley MB, Cairo MS (2008) Stem cell transplantation for paediatric lymphoma: past, present and future. Bone Marrow Transplant 41:149–158PubMedCrossRef

74.

Claviez A, Canals C, Dierickx D et al (2009) Allogeneic hematopoietic stem cell transplantation in children and adolescents with recurrent and refractory Hodgkin lymphoma: an analysis of the European Group for Blood and Marrow Transplantation. Blood 114:2060–2067PubMedCrossRef

75.

Locatelli F, Neville K, Rosolen A et al Phase 1/2 study of Brentuximab vedotin in pediatric patients with relapsed or refractory (R/R) Hodgkin lymphoma (HL) or systemic anaplastic large-cell lymphoma (sALCL): preliminary phase 2 data for Brentuximab vedotin 1.8 Mg/Kg in the HL study arm. 2013; 55th ASH Annual Meeting abstract number 4378

76.

Marina NM, Greenwald CA, Fairclough DL et al (1995) Serial pulmonary function studies in children treated for newly diagnosed Hodgkin’s disease with mantle radiotherapy plus cycles of cyclophosphamide, vincristine, and procarbazine alternating with cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine. Cancer 75:1706–1711PubMedCrossRef

77.

Mefferd JM, Donaldson SS, Link MP (1989) Pediatric Hodgkin’s disease: pulmonary, cardiac, and thyroid function following combined modality therapy. Int J Radiat Oncol Biol Phys 16:679–685PubMedCrossRef

78.

Green DM, Hall B (1988) Pregnancy outcome following treatment during childhood or adolescence for Hodgkin’s disease. Pediatr Hematol Oncol 5:269–277PubMedCrossRef

79.

Hudson MM, Poquette CA, Lee J et al (1998) Increased mortality after successful treatment for Hodgkin’s disease. J Clin Oncol 16:3592–3600PubMed

80.

Adams MJ, Lipsitz SR, Colan SD et al (2004) Cardiovascular status in long-term survivors of Hodgkin’s disease treated with chest radiotherapy. J Clin Oncol 22:3139–3148PubMedCrossRef

81.

Green DM, Hyland A, Chung CS et al (1999) Cancer and cardiac mortality among 15-year survivors of cancer diagnosed during childhood or adolescence. J Clin Oncol 17:3207–3215PubMed

82.

Constine LS, Tarbell N, Hudson MM et al (2008) Subsequent malignancies in children treated for Hodgkin’s disease: associations with gender and radiation dose. Int J Radiat Oncol Biol Phys 72:24–33PubMedCentralPubMedCrossRef

83.

Hodgson DC, Hudson MM, Constine LS (2007) Pediatric Hodgkin lymphoma: maximizing efficacy and minimizing toxicity. Semin Radiat Oncol 17:230–242PubMedCrossRef

84.

Rubin P, Williams JP, Deveson SS, Travis LB, Constine LS (2010) Semin Radiat Oncol 20(1):3–11PubMedCrossRef

85.

Punnett A, Tsang R, Hodgson DC (2010) Hodgkin lymphoma across the age spectrum: epidemiology, therapy, and late effects. Semin Radiat Oncol 20(1):30–44PubMedCrossRef

86.

Sankila R, Garwicz S, Olsen JH et al (1996) Risk of subsequent malignant neoplasms among 1,641 Hodgkin’s disease patients diagnosed in childhood and adolescence: a population-based cohort study in the five Nordic countries. Association of the Nordic Cancer Registries and the Nordic Society of Pediatric Hematology and Oncology. J Clin Oncol 14:1442–1446PubMed

87.

Ruhl U, Albrecht M, Dieckmann K et al (2001) Response-adapted radiotherapy in the treatment of pediatric Hodgkin’s disease: an interim report at 5 years of the German GPOH-HD-95 trial. Int J Radiat Oncol Biol Phys 51:1209–1218PubMedCrossRef

88.

Hudson MM, Krasin M, Link MP et al (2004) Risk-adapted, combined-modality therapy with VAMP/COP and response-based, involved-field radiation for unfavorable pediatric Hodgkin’s disease. J Clin Oncol 22:4541–4550PubMedCrossRef

89.

Oberlin O, Boilletot A, Leverger G et al (1985) Clinical staging, primary chemotherapy and involved-field radiotherapy in childhood Hodgkin’s disease. Eur Paediatr Oncol 2:65–70CrossRef

90.

Oberlin O, Leverger G, Pacquement M et al (1992) Low-dose radiation therapy and reduced chemotherapy in childhood Hodgkin’s disease: the experience of the French Society of Pediatric Oncology. J Clin Oncol 10:1602–1608PubMed

91.

Schellong G (1996) Treatment of children and adolescents with Hodgkin’s disease: the experience of the German-Austrian Paediatric Study Group. Bailliere’s Clin Haematol 9:619–634CrossRef

92.

Shankar A, Ashley S, Radford M et al (1997) Does histology influence outcome in childhood Hodgkin’s disease? Results from the United Kingdom Children’s Cancer Study Group. J Clin Oncol 15:2622–2630PubMed

93.

Vecchi V, Pileri S, Burnelli R et al (1993) Treatment of pediatric Hodgkin disease tailored to stage, mediastinal mass, and age. Cancer 72:2049–2057PubMedCrossRef

94.

Atra A, Higgs E, Capra M et al (2002) ChlVPP chemotherapy in children with stage IV Hodgkin’s disease: results of the UKCCSG HD 8201 and HD 9201 studies. Br J Haematol 119:647–651PubMedCrossRef

95.

Wolden SL, Lamborn KR, Cleary SF et al (1998) Second cancers following pediatric Hodgkin’s disease. J Clin Oncol 16:536–544PubMed

96.

Green DM, Hyland A, Barcos MP et al (2000) Second malignant neoplasms after treatment for Hodgkin’s disease in childhood or adolescence. J Clin Oncol 18:1492–1499PubMed

97.

Bhatia S, Robison LL, Oberlin O et al (1996) Breast cancer and other second neoplasms after childhood Hodgkin’s disease. N Engl J Med 334:745–751PubMedCrossRef

98.

Metayer C, Lynch CF, Clarke EA et al (2000) Second cancers among long-term survivors of Hodgkin’s disease diagnosed in childhood and adolescence. J Clin Oncol 18:2435–2443PubMed

Medicine Matters Oncology

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