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

Autores
Veron, David; Streitenberger, Patricia; Matus, Mónica; Negri Aranguren, Pedro; Costa, Alejandra; Morell, Daniela; Terrasa, Sergio Adrian; Castellanos, E. Mauricio; de Alarcon, Pedro; Dibar, Eduardo; Makiya, Mónica
Año de publicación
2025
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
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.
Fil: Veron, David. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Streitenberger, Patricia. Hospital Italiano; Argentina
Fil: Matus, Mónica. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Negri Aranguren, Pedro. Hospital Materno Infantil San Roque ; Gobierno de la Provincia de Entre Rios;
Fil: Costa, Alejandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; Argentina
Fil: Morell, Daniela. Hospital Infantil ; Municipalidad de la Ciudad de Cordoba (cordoba);
Fil: Terrasa, Sergio Adrian. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Castellanos, E. Mauricio. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: de Alarcon, Pedro. University of Illinois; Estados Unidos
Fil: Dibar, Eduardo. Hospital Italiano; Argentina
Fil: Makiya, Mónica. Hospital Italiano; Argentina
Materia
COPDAC
GATLA
Hodgkin
OEPA
pediatric
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/279672
Acceder
id CONICETDig_eab75111f3120136b0a8aefa901ae80e
oai_identifier_str oai:ri.conicet.gov.ar:11336/279672
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA ExperienceVeron, DavidStreitenberger, PatriciaMatus, MónicaNegri Aranguren, PedroCosta, AlejandraMorell, DanielaTerrasa, Sergio AdrianCastellanos, E. Mauriciode Alarcon, PedroDibar, EduardoMakiya, MónicaCOPDACGATLAHodgkinOEPApediatrichttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: 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.Fil: Veron, David. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Streitenberger, Patricia. Hospital Italiano; ArgentinaFil: Matus, Mónica. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: Negri Aranguren, Pedro. Hospital Materno Infantil San Roque ; Gobierno de la Provincia de Entre Rios;Fil: Costa, Alejandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; ArgentinaFil: Morell, Daniela. Hospital Infantil ; Municipalidad de la Ciudad de Cordoba (cordoba);Fil: Terrasa, Sergio Adrian. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Castellanos, E. Mauricio. Universidad Austral. Hospital Universitario Austral; ArgentinaFil: de Alarcon, Pedro. University of Illinois; Estados UnidosFil: Dibar, Eduardo. Hospital Italiano; ArgentinaFil: Makiya, Mónica. Hospital Italiano; ArgentinaHindawi Publishing Corporation2025-07info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/279672Veron, David; Streitenberger, Patricia; Matus, Mónica; Negri Aranguren, Pedro; Costa, Alejandra; et al.; Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience; Hindawi Publishing Corporation; Advances in Hematology; 2025; 1; 7-2025; 1-81687-91041687-9112CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1155/ah/5453729info:eu-repo/semantics/altIdentifier/doi/10.1155/ah/5453729info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2026-02-26T10:01:23Zoai:ri.conicet.gov.ar:11336/279672instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982026-02-26 10:01:23.468CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
title Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
spellingShingle Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
Veron, David
COPDAC
GATLA
Hodgkin
OEPA
pediatric
title_short Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
title_full Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
title_fullStr Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
title_full_unstemmed Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
title_sort Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience
dc.creator.none.fl_str_mv Veron, David
Streitenberger, Patricia
Matus, Mónica
Negri Aranguren, Pedro
Costa, Alejandra
Morell, Daniela
Terrasa, Sergio Adrian
Castellanos, E. Mauricio
de Alarcon, Pedro
Dibar, Eduardo
Makiya, Mónica
author Veron, David
author_facet Veron, David
Streitenberger, Patricia
Matus, Mónica
Negri Aranguren, Pedro
Costa, Alejandra
Morell, Daniela
Terrasa, Sergio Adrian
Castellanos, E. Mauricio
de Alarcon, Pedro
Dibar, Eduardo
Makiya, Mónica
author_role author
author2 Streitenberger, Patricia
Matus, Mónica
Negri Aranguren, Pedro
Costa, Alejandra
Morell, Daniela
Terrasa, Sergio Adrian
Castellanos, E. Mauricio
de Alarcon, Pedro
Dibar, Eduardo
Makiya, Mónica
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv COPDAC
GATLA
Hodgkin
OEPA
pediatric
topic COPDAC
GATLA
Hodgkin
OEPA
pediatric
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv 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.
Fil: Veron, David. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Streitenberger, Patricia. Hospital Italiano; Argentina
Fil: Matus, Mónica. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: Negri Aranguren, Pedro. Hospital Materno Infantil San Roque ; Gobierno de la Provincia de Entre Rios;
Fil: Costa, Alejandra. Provincia de Buenos Aires. Ministerio de Salud. Hospital de Niños "Sor María Ludovica" de La Plata; Argentina
Fil: Morell, Daniela. Hospital Infantil ; Municipalidad de la Ciudad de Cordoba (cordoba);
Fil: Terrasa, Sergio Adrian. Instituto Universidad Escuela de Medicina del Hospital Italiano; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Castellanos, E. Mauricio. Universidad Austral. Hospital Universitario Austral; Argentina
Fil: de Alarcon, Pedro. University of Illinois; Estados Unidos
Fil: Dibar, Eduardo. Hospital Italiano; Argentina
Fil: Makiya, Mónica. Hospital Italiano; Argentina
description 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.
publishDate 2025
dc.date.none.fl_str_mv 2025-07
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/279672
Veron, David; Streitenberger, Patricia; Matus, Mónica; Negri Aranguren, Pedro; Costa, Alejandra; et al.; Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience; Hindawi Publishing Corporation; Advances in Hematology; 2025; 1; 7-2025; 1-8
1687-9104
1687-9112
CONICET Digital
CONICET
url http://hdl.handle.net/11336/279672
identifier_str_mv Veron, David; Streitenberger, Patricia; Matus, Mónica; Negri Aranguren, Pedro; Costa, Alejandra; et al.; Risk‐Stratified and Response‐Adapted Therapy for Pediatric Hodgkin Lymphoma in Argentina: The GATLA Experience; Hindawi Publishing Corporation; Advances in Hematology; 2025; 1; 7-2025; 1-8
1687-9104
1687-9112
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/10.1155/ah/5453729
info:eu-repo/semantics/altIdentifier/doi/10.1155/ah/5453729
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Hindawi Publishing Corporation
publisher.none.fl_str_mv Hindawi Publishing Corporation
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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score 13.176822

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