CCCG-HD-2018 for Children and Adolescents With Newly Diagnosed Hodgkin Lymphoma

Phase

Condition

Hematologic Cancer

Lymphoma

White Cell Disorders

Treatment

Combined chemotherapy with or without involved-field radiotherapy

Clinical Study ID

NCT04726501

CCCG-HD-2018

Ages 1-18
All Genders

Study Summary

The incidence of Hodgkin's lymphoma (HL) in Chinese children and adolescents is only 1 / 10 of that in Europe and the United States, which is a "rare" childhood tumor. Due to the "drug shortage" and extremely low incidence, it has brought great difficulties to the domestic clinical research and failed to achieve the desired effect. In this study, we apply a well-documented effective protocol on newly diagnosed children and adolescents with HL to understand whether the same treatment regimens can obtain similar event free survival rates and overall survival rates and then find out the problems existing in the current clinical care of HL in China, so as to make continuous improvement in the future and prepare for innovative clinical research.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Patient must be ages 1 to 18 years at the time of diagnosis; Newly diagnosed,histologically confirmed Hodgkin disease (No nodular lymphocyte-predominant Hodgkinlymphoma)

Exclusion

Exclusion Criteria:

Patients have received prior cytotoxic chemotherapy for the current diagnosis or anycancer, if any steroid applied, total prior steroids dosage < Prednisone 80 mg/m2;Patients have congenital immunodeficiency, HIV infection, or prior organ transplant;Patients have overwhelming infection, and a life expectancy of < 2 weeks

Study Design

Combined chemotherapy with or without involved-field radiotherapy

April 01, 2018

December 31, 2027

Study Description

In this study, enrolled patients from age 1 through 18 years with newly diagnosed and biopsy-proven HL are stratified into 3 risk groups according to 3 COG published trials: AHOD0831 (high risk-all Ann Arbor stages III and IV with B symptoms), AHOD0031 (intermediate risk-Ann Arbor stages IB, IAE, IIB, IIAE, IIIA, IVA with or without bulk disease, and IA or IIA with bulk disease) and AHOD0431 (low risk-Ann Arbor stage IA or IIA without bulky disease). Staging was determined with contrast-enhanced CT scanning or MRI, bilateral bone marrow biopsies and FDG-PET. B symptoms included weight loss > 10%, unexplained recurrent fever > 38°, or drenching night sweats. Bulk disease included a mediastinal mass with diameter greater than one third of the thoracic diameter on an upright anterior-posterior (AP) chest radiograph or extramediastinal nodal aggregate > 6 cm in the longest transverse diameter on axial CT.

Low risk group: Patients receive 2 cycles of doxorubicin,vincristine, etoposide, cyclophosphamide, and prednisone (AVE-PC) followed by early response (ER) evaluation. Rapid early responders (RERs) receive 2 additional AVE-PC cycles. Slow early responders (SERs) receive 2 additional ABVE-PC cycles followed by involved-field radiotherapy (IFRT). IFRT consists of 21 Gy in 14 fractions of 1.5 Gy per day and is scheduled within 4 weeks after chemotherapy.

Intermediate risk group: Patients receive 2 cycles of doxorubicin, bleomycin, vincristine, etoposide, cyclophosphamide, and prednisone (ABVE-PC) followed by ER evaluation. RERs receive 2 additional ABVE-PC cycles. SERs receive 2 additional ABVE-PC cycles followed by IFRT. IFRT consists of 21 Gy in 14 fractions of 1.5 Gy per day and is scheduled within 4 weeks after chemotherapy.

High risk group: Patients receive 2 cycles of ABVE-PC followed by ER evaluation. RERs receive 2 additional ABVE-PC cycles followed by IFRT. SERs receive 2 cycles of IFOS/VINO and 2 cycles of ABVE-PC followed by IFRT. IFRT consists of 21 Gy in 14 fractions of 1.5 Gy per day and is scheduled within 4 weeks after chemotherapy.

Patients who have disease progression at any time will be removed from this protocol.

Connect with a study center

West China Second University Hospital, Sichuan University, Chengdu, China
Chengdu,
China
Site Not Available
Nanjing Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
Nanjing,
China
Site Not Available
Shanghai Children's Medical Center
Shanghai, 200127
China
Site Not Available

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