Modern concepts in the treatment of classical Hodgkin lymphoma in children and adolescents

Over the past century, classical Hodgkin lymphoma (HL) has evolved from a fatal disease to one of the most curable cancers. Treatment protocols for pediatric patients with HL have been developed by the world's major research consortia: the Children's Oncology Group (COG) and the European Network-Paediatric HL Study Group (EuroNet-PHL). Their efforts are devoted to identifying ways to reduce the indications for radiation therapy and to use smaller field sizes and reduced doses of radiation therapy as well as lower doses of chemotherapy with the aim to reduce early mortality and potential toxicity in the long term. These protocols rely on risk-adapted treatment programs based on early response to chemotherapy, which has become a determining factor for the use of radiotherapy. Positron emission tomography has taken a leading role in staging and evaluation of treatment response. The aim of this review is to summarize current understanding of pediatric classical HL treatment according to the approaches of the COG and EuroNet-PHL research consortia.