Klin Padiatr 2014; 226 - P_22
DOI: 10.1055/s-0034-1371133

Pediatric Hodgkin Lymphoma through Clinical Trials in Argentina in the Past 46 Years: The GATLA Experience

DA Veron 1, P Streitenberger 1, M García 1, F Lastiri 1, E Schvartzman 1, S Pavlovsky 1, E Dibar 1, D Freigeiro 1, CM HL-GATLA 1
  • 1GATLA, Buenos Aires, Argentina

Background: GATLA has a 46 year (y) long experience of cooperative trials for lymphomas.

Aim: Describe the outcome of pediatric patients enrolled on consecutive trials including 2 exclusively pediatric trials for Hodgkin lymphoma.

Methods: 1110 pediatric patients (pts) were enrolled in 7 protocols: 11-LH-72: 140 pts, stage I-IV, COPP (cyclophosphamide/vincristine/procarbazine/prednisone) x 6 cycles (± maintenance therapy with CCNU for Stage I-IIB, III and IV) + IFRT. 9-H-77/79: 203 pts, stage I-IV, CV (vinblastine) PP x 6 cycles ± IFRT after the 3rd cycle. 11-H-79: 34 pts, stage IIIB-IV, ACOP (doxorubicin/cyclophosphamide/vincristine/prednisone)-BVP (bleomycine/vinblastine/procarbazine) x 8 cycles. 11-H-84: 16 pts, stage III-IV, CAVPE (cyclophosphamide/doxorubicin/vinblastine/prednisone/VP-16) x 8 cycles. 11-H-86: 260 pts. Favorable risk: CVPP x 3 vs. 6. Intermediate risk: CVPP vs. AOPE (doxorubicine/vincristine/prednisone/VP-16) x 6 + IFRT (30 Gy) after the 3rd cycle. 7-H-87: 67 pts unfavorable risk: C (CCNU) OPP alternating with CAPTe (cyclophosphamide/doxorubicine/prednisone/tenoposide) x 6 cycles (3 of each combination) + IFRT (40 Gy). 7-Pediatric-HD-96: 351 pts. Low risk: COPP-ABV (doxorubicine/bleomycine/vinblastine) x 4 + IFRT (poor responders). High risk: COPP-ABV x 6 + IFRT (bulky disease and poor responders: 20/25 Gy according to age). EHP- 10: 39 pts. Low risk: ABVD x 3 ± IFRT (25 Gy). Intermediate risk: ABVD x 3 + IFRT (25 Gy) or ABVD x 6 + IFRT (25 Gy) poor responders. High risk: ABVD x 6 + IFRT (30 Gy).

Results: 10 y OS: 11-LH-72: 79%, 9-H-77: 83%, 11-H-79: 81%, 11-H-84: 62%, 11-H-86: 89%, 7-H-87: 69%. 7-P-HD-96: Low risk: 5 y EFS: 76%, 5 y OS: 94%. High risk: 5 y EFS: 67%, 5 y OS: 85%. EHP-10: poor patient enrollment.

Conclusion: There has been a constant outcome improvement in Argentina through clinical trial participation. Recently we began an international cooperative work with AHOPCA and SJCRH adopting OEPA/COPDAC strategy for high risk pts.