De Re Valli, Repetto Ombretta, Mussolin Lara, Brisotto Giulia, Elia Caterina, Lopci Egesta, d'Amore Emanuele S G, Burnelli Roberta, Mascarin Maurizio
Immunopatologia e Biomarcatori Oncologici, Dipartimento di Ricerca e Diagnostica Avanzata dei Tumori, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Aviano, Italy.
Pediatric Hemato-Oncology Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy.
Front Cell Dev Biol. 2022 Nov 24;10:965803. doi: 10.3389/fcell.2022.965803. eCollection 2022.
Currently-available therapies for newly-diagnosed pediatric and adolescent patients with Hodgkin lymphoma result in >95% survival at 5 years. Long-term survivors may suffer from long-term treatment-related side effects, however, so the past 20 years have seen clinical trials for children and adolescents with HL gradually abandon the regimens used in adults in an effort to improve this situation. Narrower-field radiotherapy can reduce long-term toxicity while maintaining good tumor control. Various risk-adapted chemo-radiotherapy strategies have been used. Early assessment of tumor response with interim positron emission tomography and/or measuring metabolic tumor volume has been used both to limit RT in patients with favorable characteristics and to adopt more aggressive therapies in patients with a poor response. Most classical Hodgkin's lymphoma relapses occur within 3 years of initial treatment, while relapses occurring 5 years or more after diagnosis are rare. As the outcome for patients with relapsed/refractory classical Hodgkin lymphoma remains unsatisfactory, new drugs have been proposed for its prevention or treatment. This review summarizes the important advances made in recent years in the management of pediatric and adolescent with classical Hodgkin lymphoma, and the novel targeted treatments for relapsed and refractory classical Hodgkin lymphoma.
目前,针对新诊断的儿童和青少年霍奇金淋巴瘤患者的现有疗法可使5年生存率超过95%。然而,长期存活者可能会遭受与长期治疗相关的副作用,因此在过去20年中,针对儿童和青少年霍奇金淋巴瘤的临床试验逐渐摒弃了成人使用的治疗方案,以改善这种情况。缩小照射野的放疗可以在维持良好肿瘤控制的同时降低长期毒性。已经采用了各种风险适应性放化疗策略。利用中期正电子发射断层扫描和/或测量代谢肿瘤体积对肿瘤反应进行早期评估,既用于限制对特征良好的患者进行放疗,也用于对反应不佳的患者采取更积极的治疗方法。大多数经典霍奇金淋巴瘤复发发生在初始治疗的3年内,而诊断后5年或更长时间出现的复发很少见。由于复发/难治性经典霍奇金淋巴瘤患者的治疗效果仍然不尽人意,因此已提出使用新药来预防或治疗该病。本综述总结了近年来在儿童和青少年经典霍奇金淋巴瘤管理方面取得的重要进展,以及针对复发和难治性经典霍奇金淋巴瘤的新型靶向治疗方法。