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Risk-adapted treatment paradigms
Source: Childhood Hodgkin Lymphoma Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 16, 2025 · Captured 2026-09-09.
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No single treatment approach is ideal for all pediatric and young adult patients because of differences in age-related developmental status and sex-related sensitivity to chemotherapy toxicity.
The general treatment strategy for children and adolescents with Hodgkin lymphoma is chemotherapy, with or without radiation.
The general treatment strategy for children and adolescents with Hodgkin lymphoma is chemotherapy, with or without radiation.
The rapidity and degree of response may determine the number of cycles and intensity of chemotherapy as well as the radiation dose and volume. The primary exception to this strategy is in patients with NLPHL, when surgical resection has been advocated for stage I disease with a single resectable node in the United States [27] and for any resectable disease in Europe.[28]
The general treatment strategy for children and adolescents with Hodgkin lymphoma is chemotherapy, with or without radiation.
Sex-based regimens were designed because male patients are vulnerable to gonadal toxicity from alkylating-agent chemotherapy, and female patients have a substantial risk of breast cancer after chest irradiation. In addition, males may experience a higher risk of cardiovascular disease after chest irradiation, which suggests limiting radiation exposure in males.[29]
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Ongoing trials for patients with favorable disease are evaluating the effectiveness of treatment with fewer cycles of combination chemotherapy alone that limit doses of anthracyclines, alkylating agents, and radiation therapy. Contemporary trials for patients with intermediate/unfavorable disease are testing whether chemotherapy and radiation therapy can be limited in patients who achieve a rapid early response to dose-intensive chemotherapy regimens. Trials have and are also testing the efficacy of regimens integrating novel, potentially less-toxic agents such as brentuximab vedotin and immune modulating therapies such as checkpoint inhibitors.[30]
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