Chemotherapy With or Without Additional Chemotherapy and/or Radiation Therapy in Treating Children With Newly Diagnosed Hodgkin's Disease
Childhood Lymphocyte-Depleted Classical Hodgkin Lymphoma, Childhood Mixed Cellularity Classical Hodgkin Lymphoma, Childhood Nodular Lymphocyte Predominant Hodgkin Lymphoma
About this trial
This is an interventional treatment trial for Childhood Lymphocyte-Depleted Classical Hodgkin Lymphoma
Eligibility Criteria
Inclusion Criteria: Patients with newly diagnosed, pathologically confirmed Hodgkin disease (all histologies) are eligible for this protocol if they meet the following clinical stage guidelines: All Stage IB regardless of bulk disease All Stage IIB regardless of bulk disease Stage IA only with bulk disease Stage IIA only with bulk disease All Stage IAE, IIAE regardless of bulk disease All Stage IIIA, IIIAE, IIIAS, IIIAE+S regardless of bulk disease All Stage IVA, IVAE regardless of bulk disease May not be staged by laparotomy alone Surgically staged patients must also have presurgical staging Bilirubin no greater than 1.5 times normal SGOT or SGPT less than 2.5 times normal Creatinine no greater than 1.5 times normal Creatinine clearance greater than 40 mL/min Radioisotope glomerular filtration rate greater than 70 mL/min Shortening fraction at least 27% by echocardiogram Ejection fraction at least 50% by MUGA No pathologic prolongation of QTc interval on 12-lead electrocardiogram FEV_1/FVC greater than 60% by pulmonary function test Pulse oximetry greater than 94% No evidence of dyspnea at rest No exercise intolerance Adequate venous access Not pregnant or nursing Negative pregnancy test Fertile patients must use effective contraception No prior chemotherapy At least 1 month since prior corticosteroids except prednisone for respiratory distress No prior radiotherapy
Sites / Locations
- University of Alabama at Birmingham Cancer Center
- Phoenix Childrens Hospital
- University of Arkansas for Medical Sciences
- Southern California Permanente Medical Group
- City of Hope Comprehensive Cancer Center
- Loma Linda University Medical Center
- Children's Hospital Los Angeles
- Cedars-Sinai Medical Center
- David Geffen School of Medicine at UCLA
- Children's Hospital Central California
- Kaiser Permanente-Oakland
- Children's Hospital of Orange County
- University of California Davis Comprehensive Cancer Center
- Rady Children's Hospital - San Diego
- Santa Barbara Cottage Hospital
- Children's Hospital Colorado
- Yale University
- Alfred I duPont Hospital for Children
- Children's National Medical Center
- Broward Health Medical Center
- Lee Memorial Health System
- University of Florida
- Memorial Regional Hospital/Joe DiMaggio Children's Hospital
- Nemours Children's Clinic-Jacksonville
- University of Miami Miller School of Medicine-Sylvester Cancer Center
- Nicklaus Children's Hospital
- Baptist Hospital of Miami
- Florida Hospital Orlando
- Nemours Children's Clinic - Orlando
- All Children's Hospital
- Saint Joseph's Hospital/Children's Hospital-Tampa
- Saint Mary's Hospital
- Georgia Regents University Medical Center
- University of Hawaii Cancer Center
- Saint Luke's Mountain States Tumor Institute
- Lurie Children's Hospital-Chicago
- University of Illinois
- University of Chicago Comprehensive Cancer Center
- Loyola University Medical Center
- Advocate Lutheran General Hospital
- Saint Jude Midwest Affiliate
- Southern Illinois University School of Medicine
- Indiana University/Melvin and Bren Simon Cancer Center
- Blank Children's Hospital
- University of Iowa/Holden Comprehensive Cancer Center
- University of Kentucky/Markey Cancer Center
- Kosair Children's Hospital
- Tulane University Health Sciences Center
- Children's Hospital New Orleans
- Eastern Maine Medical Center
- Sinai Hospital of Baltimore
- Johns Hopkins University/Sidney Kimmel Cancer Center
- Baystate Medical Center
- University of Massachusetts Medical School
- C S Mott Children's Hospital
- Wayne State University/Karmanos Cancer Institute
- Saint John Hospital and Medical Center
- Michigan State University Clinical Center
- Hurley Medical Center
- Kalamazoo Center for Medical Studies
- William Beaumont Hospital-Royal Oak
- Children's Hospitals and Clinics of Minnesota - Minneapolis
- University of Minnesota/Masonic Cancer Center
- Mayo Clinic
- University of Mississippi Medical Center
- University of Missouri - Ellis Fischel
- The Childrens Mercy Hospital
- Cardinal Glennon Children's Medical Center
- Washington University School of Medicine
- University of Nebraska Medical Center
- Nevada Cancer Research Foundation CCOP
- Dartmouth Hitchcock Medical Center
- Hackensack University Medical Center
- Saint Peter's University Hospital
- Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
- Newark Beth Israel Medical Center
- Saint Joseph's Regional Medical Center
- Overlook Hospital
- University of New Mexico Cancer Center
- Albany Medical Center
- Montefiore Medical Center - Moses Campus
- Brooklyn Hospital Center
- Roswell Park Cancer Institute
- Winthrop University Hospital
- The Steven and Alexandra Cohen Children's Medical Center of New York
- Mount Sinai Medical Center
- Columbia University/Herbert Irving Cancer Center
- Weill Medical College of Cornell University
- University of Rochester
- Stony Brook University Medical Center
- State University of New York Upstate Medical University
- New York Medical College
- Mission Hospital-Memorial Campus
- UNC Lineberger Comprehensive Cancer Center
- Carolinas Medical Center/Levine Cancer Institute
- Novant Health Presbyterian Medical Center
- Duke University Medical Center
- East Carolina University
- Wake Forest University Health Sciences
- Sanford Medical Center-Fargo
- Children's Hospital Medical Center of Akron
- Cincinnati Children's Hospital Medical Center
- Rainbow Babies and Childrens Hospital
- Cleveland Clinic Foundation
- Nationwide Children's Hospital
- Dayton Children's Hospital
- The Toledo Hospital/Toledo Children's Hospital
- University of Oklahoma Health Sciences Center
- Natalie Warren Bryant Cancer Center at Saint Francis
- Legacy Emanuel Hospital and Health Center
- Oregon Health and Science University
- Lehigh Valley Hospital - Muhlenberg
- Geisinger Medical Center
- Children's Hospital of Philadelphia
- Saint Christopher's Hospital for Children
- Children's Hospital of Pittsburgh of UPMC
- Rhode Island Hospital
- Medical University of South Carolina
- Palmetto Health Richland
- Greenville Cancer Treatment Center
- Sanford USD Medical Center - Sioux Falls
- T C Thompson Children's Hospital
- East Tennessee Childrens Hospital
- Vanderbilt University/Ingram Cancer Center
- Texas Tech University Health Science Center-Amarillo
- Dell Children's Medical Center of Central Texas
- Driscoll Children's Hospital
- Medical City Dallas Hospital
- UT Southwestern/Simmons Cancer Center-Dallas
- Cook Children's Medical Center
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
- M D Anderson Cancer Center
- Covenant Children's Hospital
- Methodist Children's Hospital of South Texas
- University of Texas Health Science Center at San Antonio
- Scott and White Memorial Hospital
- Primary Children's Hospital
- University of Vermont College of Medicine
- University of Virginia Cancer Center
- Inova Fairfax Hospital
- Childrens Hospital-King's Daughters
- Naval Medical Center - Portsmouth
- Virginia Commonwealth University/Massey Cancer Center
- Carilion Clinic Children's Hospital
- Seattle Children's Hospital
- Providence Sacred Heart Medical Center and Children's Hospital
- Mary Bridge Children's Hospital and Health Center
- Madigan Army Medical Center
- West Virginia University Charleston
- Saint Vincent Hospital
- University of Wisconsin Hospital and Clinics
- Marshfield Clinic
- Midwest Children's Cancer Center
- Royal Brisbane and Women's Hospital
- Women's and Children's Hospital-Adelaide
- Princess Margaret Hospital for Children
- Alberta Children's Hospital
- University of Alberta Hospital
- British Columbia Children's Hospital
- CancerCare Manitoba
- Janeway Child Health Centre
- IWK Health Centre
- Chedoke Hospital at Hamilton Health Sciences
- Cancer Centre of Southeastern Ontario at Kingston General Hospital
- Children's Hospital of Eastern Ontario
- Hospital for Sick Children
- Centre Hospitalier Universitaire Sainte-Justine
- Allan Blair Cancer Centre
- Saskatoon Cancer Centre
- Centre Hospitalier Universitaire de Quebec
- Schneider Children's Medical Center of Israel
- Starship Children's Hospital
- Christchurch Hospital
- San Jorge Children's Hospital
- Swiss Pediatric Oncology Group - Geneva
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Arm I (Patients off-therapy before callback-Induction only)
Arm II (RER with CR [ABVE-PC, IFRT])
Arm III (RER with CR [ABVE-PC])
Arm IV (RER with less than CR [ABVE-PC, IFRT])
Arm V (RER with PD)
Arm VI (SER [DECA, ABVE-PC, IFRT])
Arm VII (SER [ABVE-PC, IFRT])
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin sulfate IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, oral prednisone 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease.
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, prednisone PO 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease. Patients receive an additional 2 courses of ABVE-PC. Patients with sustained CR undergo IFRT approximately 3 weeks after the last day of ABVE course 4.
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, prednisone PO 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease. Patients receive an additional 2 courses of ABVE-PC. Patients with sustained CR are randomized to receive no further treatment.
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, prednisone PO 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease. Patients receive an additional 2 courses of ABVE-PC. Patients with VGPR, PR or SD undergo IFRT approximately 3 weeks after the last day of ABVE-PC course 4 for 5 days a week.
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, prednisone PO 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease. Patients with PD are taken off therapy.
Patients receive dexamethasone IV over 15 minutes, etoposide IV over 3 hours, and cytarabine IV over 3 hours on days 1-2. Patients receive 2 drops of dexamethasone ophthalmic solution every 6 hours on days 1, 2 and 3. Patients also receive cisplatin PO or IV over 12 hours as pre-hydration followed by continuous IV over 6 hours on day 1 and G-CSF SC beginning on day 3 and continuing until blood counts recover. Treatment repeats every 21 days for 2 courses in the absence of disease progression or unacceptable toxicity. Patients then receive 2 additional courses of ABVE-PC chemotherapy. Patients with sustained complete or partial response undergo IFRT approximately 3 weeks after the last course of chemotherapy.
Patients receive doxorubicin IV over 10-30 minutes on days 1-2, bleomycin IV over 10-20 minutes or SC and vincristine IV on days 1 and 8, etoposide IV over 1 hour on days 1-3, prednisone PO 2 or 3 times daily on days 1-7, and cyclophosphamide IV over 1 hour on day 1. Patients receive filgrastim (G-CSF) SC beginning on day 2 and continuing until blood counts recover (G-CSF is held on day 8). Treatment repeats every 21 days for 2 courses in the absence of progressive disease. Patients receive 2 additional courses of ABVE-PC. Patients with sustained complete or partial response undergo IFRT approximately 3 weeks after the last course of chemotherapy.