Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
Pediatrics, New York Medical College, Valhalla, NY, USA.
Best Pract Res Clin Haematol. 2023 Mar;36(1):101445. doi: 10.1016/j.beha.2023.101445. Epub 2023 Feb 3.
Advances in the management of Hodgkin lymphoma in children, adolescents and young adult have resulted in survival outcomes exceeding 90%. The risk of late toxicity, however, remains a significant concern for survivors of HL and the focus of modern trials have been to advance cure rates while reducing long term toxicity. This has been accomplished through response-adapted treatment approaches and the incorporation of novel agents, many of which target the unique interaction between the Hodgkin and Reed Sternberg cells and the tumor microenvironment. In addition, an improved understanding of prognostic markers, risk stratification, and the biology of this entity in children and AYAs may allow us to further tailor therapy. This review focuses on the current management of HL in the upfront and relapsed settings, recent advances in novel agents that target HL and the tumor microenvironment, and promising prognostic markers that may help guide the future management of HL.
霍奇金淋巴瘤在儿童、青少年和青年中的治疗进展已使得其生存率超过 90%。然而，迟发性毒性的风险仍然是 HL 幸存者的一个重大关注点，现代试验的重点是在降低长期毒性的同时提高治愈率。这通过适应性反应治疗方法和新型药物的应用来实现，其中许多药物针对霍奇金和里德-斯特恩伯格细胞与肿瘤微环境之间的独特相互作用。此外，对儿童和 AYA 中该实体的预后标志物、风险分层和生物学的更好理解可能使我们能够进一步调整治疗。这篇综述重点关注初治和复发霍奇金淋巴瘤的当前治疗方法、针对霍奇金淋巴瘤和肿瘤微环境的新型药物的最新进展，以及可能有助于指导未来霍奇金淋巴瘤治疗的有前途的预后标志物。
