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Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols

Pediatric Hemato-Oncology Unit, Azienda Ospedaliero Universitaria Sant’Anna di Ferrara, 44124 Cona, Ferrara, Italy
Department of Pediatrics, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico, 41121 Modena, Italy
Department of Pediatrics, Sant’Orsola Hospital, University of Bologna, 40138 Bologna, Italy
Pediatric Hematology, Oncology and Stem Cell Transplant Center, Department of Women and Child’s Health, University of Padua, 35122 Padova PD, Italy
Department of Paediatrics, Ospedale San Gerardo, University of Milano-Bicocca, Fondazione MBBM, 20900 Monza, Italy
Department of Pediatric Oncology, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
Department of Pathological Anatomy, San Bortolo Hospital, 36100 Vicenza, Italy
Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, 40126 Bologna, Italy
Paediatric Haemato-Oncology Department, Santobono-Pausilipon Children’s Hospital, 80122 Napoli, Italy
Pediatric Onco-Hematology and Stem Cell Transplant Division, City of Health and Science, Regina Margherita Children’s Hospital, 10126 Turin, Italy
Department of Pediatric Hematology and Oncology, IRCSS Ospedale Bambino Gesù, 00165 Rome, Italy
Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
Department of Pediatric Oncology and Hematology, University Hospital of Policlinico, 70124 Bari, Italy
Department of Pediatrics, Civic Hospital, 24127 Bergamo, Italy
Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, 90127 Palermo, Italy
Department of Woman, Child and of General and Specialist Surgery, Second University of Naples, 81100 Naples, Italy
Department of Clinical and Experimental Medicine, Paediatric Haemato-Oncology Unit, University of Catania, 95124 Catania, Italy
Pediatric Hematology Oncology, Bone Marrow Transplant, S. Chiara University Hospital of Pisa, 56126 Pisa, Italy
IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, 47156 Foggia, Italy
Paediatric Haematology-Oncology Unit, Meyer Paediatric Hospital, 50139 Florence, Italy
Oncology-Hematology and BMT Unit, Ospedale dei Bambini, Spedali Civili, 25123 Brescia, Italy
Division of Pediatric Hematology and Oncology, Ospedale G. Salesi, 60123 Ancona, Italy
Pediatric Hematology and Oncology Unit, Ospedale Pediatrico Microcitemico, 09121 Cagliari, Italy
Paediatric Onco-Haematology Unit, “Burlo Garofolo” Hospital, 34137 Trieste, Italy
Pediatric Hematology-Oncology Unit, Ospedale Civico, Pescara, Italy
Pediatric Hematology Oncology Unit, Department of Mother and Child, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy
Pediatric Hematology-Oncology Unit, S. Maria della Misericordia Hospital, 65124 Perugia, Italy
Pediatric Hematology Oncology Unit, Azienda Ospedaliero Universitaria of Parma, 43126 Parma, Italy
Pediatric Unit, Azienda Ospedaliera Annunziata, 87100 Cosenza, Italy
Pediatric Oncology Unit, Infermi Hospital, 47923 Rimini, Italy
Azienda Ospedaliero Universitaria Senese Policlinico “Le Scotte”, Clinica Pediatrica, 53100 Siena, Italy
Pediatric Rheumatology and Immunology, PO “Vito Fazzi”, 73100 Lecce, Italy
AYA Oncology and Pediatric Radiotherapy Unit, CRO-Centro di Riferimento Oncologico di Aviano, IRCCS, 33081 Aviano, Italy
Author to whom correspondence should be addressed.
Cancers 2020, 12(6), 1620;
Received: 29 April 2020 / Revised: 1 June 2020 / Accepted: 16 June 2020 / Published: 18 June 2020
Adolescents and young adults (AYAs) represent a distinct group of patients. The objectives of this study were: To compare adolescent prognosis to that of younger children; to compare the results achieved with the two consecutive protocols in both age groups; to analyze clinical characteristics of children and adolescents. Between 1996 and 2017, 1759 patients aged <18 years were evaluable for the study. Five hundred and sixty patients were treated with the MH’96 protocol and 1199 with the LH2004 protocol. Four hundred and eighty-two were adolescents aged ≥15 years. Patients in both age groups showed very favorable prognoses. In particular, OS improved with the LH2004 protocol, especially in the adolescent group and in the low risk group, where radiation therapy was spared. Adolescent characteristics differed significantly from the children’s according to sex, histology, and the presence of symptoms. Remarkable is the decrease both in mixed cellularity in the children and in low stages in both age groups in the LH2004 protocol with respect to MH’96 protocol. Based on our experience, adopting pediatric protocols for AYA does not compromise patient outcomes. View Full-Text
Keywords: Hodgkin’s lymphoma; adolescent; children; pediatric; clinical characteristics; prognosis; chemotherapy; radiotherapy; histology Hodgkin’s lymphoma; adolescent; children; pediatric; clinical characteristics; prognosis; chemotherapy; radiotherapy; histology
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Burnelli, R.; Fiumana, G.; Rondelli, R.; Pillon, M.; Sala, A.; Garaventa, A.; D’Amore, E.S.; Sabattini, E.; Buffardi, S.; Bianchi, M.; Vinti, L.; Zecca, M.; Muggeo, P.; Provenzi, M.; Farruggia, P.; Rossi, F.; D’Amico, S.; Facchini, E.; Bernasconi, S.; De Santis, R.; Casini, T.; Porta, F.; D’Alba, I.; Mura, R.; Verzegnassi, F.; Sau, A.; Cesaro, S.; Perruccio, K.; Cellini, M.; Bertolini, P.; Sperlì, D.; Pericoli, R.; Galimberti, D.; Civino, A.; Mascarin, M. Comparison of Hodgkin’s Lymphoma in Children and Adolescents. A Twenty Year Experience with MH’96 and LH2004 AIEOP (Italian Association of Pediatric Hematology and Oncology) Protocols. Cancers 2020, 12, 1620.

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