Cancer in the adolescent and young adult (AYA) is the second leading cause of nonaccidental death with hematological malignancies spiking during this period. Treatment of AYAs with hematological malignancies usually follows either pediatric or adult protocols with sufficient information lacking on subgroup analyses regarding course and outcome. In this review we will outline up-to-date treatment possibilities for AYAs diagnosed with Hodgkin's lymphoma. Early and late toxicities will be addressed and future directions of research suggested.

Bleyer A, Budd T, Montello M: Adolescents and young adults with cancer: the scope of the problem and criticality of clinical trials. Cancer 2006;107:1645-1655.
Gatta G, Capocaccia R, Coleman MP, Ries LA, Berrino F: Childhood cancer survival in Europe and the United States. Cancer 2002;95:1767-1772.
Haimi M, Perez-Nahum M, Stein N, Ben Arush MW: The role of the doctor and the medical system in the diagnostic delay in pediatric malignancies. Cancer Epidemiol 2011;35:83-89.
Schnurr C, Pippan M, Stuetzer H, Delank KS, Michael JW, Eysel P: Treatment delay of bone tumours, compilation of a sociodemographic risk profile: a retrospective study. BMC Cancer 2008;8:22.
Bleyer A: The adolescent and young adult gap in cancer care and outcome. Curr Probl Pediatr Adolesc Health Care 2005;35:182-217.
Dong HY, Harris NL, Preffer FI, Pitman MB: Fine-needle aspiration biopsy in the diagnosis and classification of primary and recurrent lymphoma: a retrospective analysis of the utility of cytomorphology and flow cytometry. Mod Pathol 2001;14:472-481.
Hehn ST, Grogan TM, Miller TP: Utility of fine-needle aspiration as a diagnostic technique in lymphoma. J Clin Oncol 2004;22:3046-3052.
Nachman JB, Sposto R, Herzog P, Gilchrist GS, Wolden SL, Thomson J, Kadin ME, Pattengale P, Davis PC, Hutchinson RJ, White K; Children's Cancer Group: Randomized comparison of low-dose involved-field radiotherapy and no radiotherapy for children with Hodgkin's disease who achieve a complete response to chemotherapy. J Clin Oncol 2002;20:3765-3771.
Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, Tesch H, Herrmann R, Dorken B, Muller-Hermelink HK, Duhmke E, Loeffler M; German Hodgkin's Lymphoma Study Group: Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin's disease. N Engl J Med 2003;348:2386-2395.
Horning SJ, Hoppe RT, Breslin S, Bartlett NL, Brown BW, Rosenberg SA: Stanford V and radiotherapy for locally extensive and advanced Hodgkin's disease: mature results of a prospective clinical trial. J Clin Oncol 2002;20:630-637.
Hodgson DC, Hudson MM, Constine LS: Pediatric Hodgkin lymphoma: maximizing efficacy and minimizing toxicity. Semin Radiat Oncol 2007;17:230-242.
Byrne J, Mulvihill JJ, Myers MH, Connelly RR, Naughton MD, Krauss MR, Steinhorn SC, Hassinger DD, Austin DF, Bragg K, et al: Effects of treatment on fertility in long-term survivors of childhood or adolescent cancer. N Engl J Med 1987;317:1315-1321.
Wolden SL, Lamborn KR, Cleary SF, Tate DJ, Donaldson SS: Second cancers following pediatric Hodgkin's disease. J Clin Oncol 1998;16:536-544.
Bhatia S, Robison LL, Oberlin O, Greenberg M, Bunin G, Fossati-Bellani F, Meadows AT: Breast cancer and other second neoplasms after childhood Hodgkin's disease. N Engl J Med 1996;334:745-751.
Aisenberg AC, Finkelstein DM, Doppke KP, Koerner FC, Boivin JF, Willett CG: High risk of breast carcinoma after irradiation of young women with Hodgkin's disease. Cancer 1997;79:1203-1210.
Mauz-Korholz C, Hasenclever D, Dorffel W, Ruschke K, Pelz T, Voigt A, Stiefel M, Winkler M, Vilser C, Dieckmann K, Karlen J, Bergstrasser E, Fossa A, Mann G, Hummel M, Klapper W, Stein H, Vordermark D, Kluge R, Korholz D: Procarbazine-free OEPA-COPDAC chemotherapy in boys and standard OPPA-COPP in girls have comparable effectiveness in pediatric Hodgkin's lymphoma: the GPOH-HD-2002 study. J Clin Oncol 2010;28:3680-3686.
Schwartz CL, Constine LS, Villaluna D, London WB, Hutchison RE, Sposto R, Lipshultz SE, Turner CS, de Alarcon PA, Chauvenet A: A risk-adapted, response-based approach using ABVE-PC for children and adolescents with intermediate- and high-risk Hodgkin lymphoma: the results of p9425. Blood 2009;114:2051-2059.
Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A, Zijlstra J, Kral Z, Fuchs M, Hallek M, Kanz L, Dohner H, Dorken B, Engel N, Topp M, Klutmann S, Amthauer H, Bockisch A, Kluge R, Kratochwil C, Schober O, Greil R, Andreesen R, Kneba M, Pfreundschuh M, Stein H, Eich HT, Muller RP, Dietlein M, Borchmann P, Diehl V; German Hodgkin Study Group; Swiss Group for Clinical Cancer Research; Arbeitsgemeinschaft Medikamentöse Tumortherapie: Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin's lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet 2012;379:1791-1799.
Kelly KM, Sposto R, Hutchinson R, Massey V, McCarten K, Perkins S, Lones M, Villaluna D, Weiner M: BEACOPP chemotherapy is a highly effective regimen in children and adolescents with high-risk Hodgkin lymphoma: a report from the Children's Oncology Group. Blood 2011;117:2596-2603.
Eichenauer DA, Bredenfeld H, Haverkamp H, Muller H, Franklin J, Fuchs M, Borchmann P, Muller-Hermelink HK, Eich HT, Muller RP, Diehl V, Engert A: Hodgkin's lymphoma in adolescents treated with adult protocols: a report from the German Hodgkin Study Group. J Clin Oncol 2009;27:6079-6085.
Engert A, Plutschow A, Eich HT, Lohri A, Dorken B, Borchmann P, Berger B, Greil R, Willborn KC, Wilhelm M, Debus J, Eble MJ, Sokler M, Ho A, Rank A, Ganser A, Trumper L, Bokemeyer C, Kirchner H, Schubert J, Kral Z, Fuchs M, Muller-Hermelink HK, Muller RP, Diehl V: Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. N Engl J Med 2010;363:640-652.
Veal GJ, Hartford CM, Stewart CF: Clinical pharmacology in the adolescent oncology patient. J Clin Oncol 2010;28:4790-4799.
Kremer LC, van Dalen EC, Offringa M, Voute PA: Frequency and risk factors of anthracycline-induced clinical heart failure in children: a systematic review. Ann Oncol 2002;13:503-512.
Josting A, Wiedenmann S, Franklin J, May M, Sieber M, Wolf J, Engert A, Diehl V; German Hodgkin's Lymphoma Study Group: Secondary myeloid leukemia and myelodysplastic syndromes in patients treated for Hodgkin's disease: a report from the German Hodgkin's Lymphoma Study Group. J Clin Oncol 2003;21:3440-3446.
Rueffer U, Josting A, Franklin J, May M, Sieber M, Breuer K, Engert A, Diehl V; German Hodgkin's Lymphoma Study Group: Non-Hodgkin's lymphoma after primary Hodgkin's disease in the german Hodgkin's Lymphoma Study Group: incidence, treatment, and prognosis. J Clin Oncol 2001;19:2026-2032.
Dores GM, Metayer C, Curtis RE, Lynch CF, Clarke EA, Glimelius B, Storm H, Pukkala E, van Leeuwen FE, Holowaty EJ, Andersson M, Wiklund T, Joensuu T, van't Veer MB, Stovall M, Gospodarowicz M, Travis LB: Second malignant neoplasms among long-term survivors of Hodgkin's disease: a population-based evaluation over 25 years. J Clin Oncol 2002;20:3484-3494.
Behringer K, Mueller H, Goergen H, Thielen I, Eibl AD, Stumpf V, Wessels C, Wiehlputz M, Rosenbrock J, Halbsguth T, Reiners KS, Schober T, Renno JH, von Wolff M, van der Ven K, Kuehr M, Fuchs M, Diehl V, Engert A, Borchmann P: Gonadal function and fertility in survivors after Hodgkin lymphoma treatment within the German Hodgkin Study Group HD13 to HD15 trials. J Clin Oncol 2013;31:231-239.
Von Tresckow B, Plutschow A, Fuchs M, Klimm B, Markova J, Lohri A, Kral Z, Greil R, Topp MS, Meissner J, Zijlstra JM, Soekler M, Stein H, Eich HT, Mueller RP, Diehl V, Borchmann P, Engert A: Dose-intensification in early unfavorable Hodgkin's lymphoma: final analysis of the German Hodgkin Study Group HD14 trial. J Clin Oncol 2012;30:907-913.
Sauer M, Plutschow A, Jachimowicz RD, Kleefisch D, Reiners KS, Ponader S, Engert A, von Strandmann EP: Baseline serum TARC levels predict therapy outcome in patients with Hodgkin lymphoma. Am J Hematol 2013;88:113-115.
Ouyang J, Plutschow A, Pogge von Strandmann E, Reiners KS, Ponader S, Rabinovich GA, Neuberg D, Engert A, Shipp MA: Galectin-1 serum levels reflect tumor burden and adverse clinical features in classical Hodgkin lymphoma. Blood 2013;121:3431-3433.
Scott DW, Chan FC, Hong F, Rogic S, Tan KL, Meissner B, Ben-Neriah S, Boyle M, Kridel R, Telenius A, Woolcock BW, Farinha P, Fisher RI, Rimsza LM, Bartlett NL, Cheson BD, Shepherd LE, Advani RH, Connors JM, Kahl BS, Gordon LI, Horning SJ, Steidl C, Gascoyne RD: Gene expression-based model using formalin-fixed paraffin-embedded biopsies predicts overall survival in advanced-stage classical Hodgkin lymphoma. J Clin Oncol 2013;31:692-700.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.