Adolescents with Hodgkin lymphoma: old children or young adults?

Hodgkin lymphoma (HL) is a malignancy of the lymphatic system with an incidence of 2-3/100,000/year in Europe and North America. The disease generally occurs in all age groups, but young adults are most often affected. Thus, adolescents aged 15 or 16 to 21 represent a relevant portion of patients. The optimum treatment for this age group is undefined. Both pediatric protocols such as OEPA (vincristine, etoposide, prednisone, adriamycin) or ABVE-PC (adriamycin, bleomycin, vincristine, etoposide, prednisone, cyclophosphamide) and adult regimens such as ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) or BEACOPP (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone) have been shown to be safe and active, resulting in long-term survival rates of 80% and more. However, a prospective comparison of pediatric and adult treatment strategies in terms of efficacy and other important questions such as treatment-related acute and long-term toxicity has not been undertaken so far. This review aims at shedding some light on potential treatment approaches for adolescents with HL and includes more recent analyses in this patient group.