Pediatric Hodgkin Lymphoma
Hodgkin lymphoma represents approximately 4% of childhood (0–14 years old) malignancies and 15% of adolescent (15–19 years old) malignancies . Bimodal incidence peaks in adolescent and adult age ranges .
The Reed-Sternberg cell, CD15+/CD30+, is a key histologic feature in classic subtypes (nodular sclerosing, lymphocyte-rich, lymphocyte-depleted, and mixed cellular) but not nodular lymphocyte predominant Hodgkin lymphoma (NLPHL).
Association with Epstein-Barr virus is highly variable (~30 to 40% in immunocompetent pediatric classical Hodgkin lymphoma, 80% + in immunocompromised patients) .
The radiation dose range in major North American trials has been 19.8–25.5 Gy in 1.5–1.8 Gy daily fractions, however, higher doses of 30 Gy are being employed among patients with imcomplete response following chemotherapy and in relapse studies.