Summary table of pediatric and adult therapeutic approaches in HL, BL, DLBCL, PMBCL, and ALCL
| . | Pediatric approach . | Adult approach . |
|---|---|---|
| HL | ||
| Stage I/II (non-bulky) | ABVE × 2-4 ± RT; VAMP × 4 ± RT; OEPA × 2 ± RT | ABVD × 4-6 with risk-adapted use of RT |
| Stage I/II (bulky) | ABVE-PC × 4 ± RT; OEPA × 2, plus COPDAC × 2 ± RT | ABVD × 4-6 plus RT in most cases |
| Stage III/IV | ABVE-PC × 4-5 plus RT in most cases; OEPA × 2, plus COPDAC × 4 ± RT | ABVD × 6 |
| BL | ||
| Low risk | COPAD × 2 | R-CODOX-M × 3, DA-EPOCH-R, or rituximab, or R-hyper-CVAD |
| High risk | FAB LMB96 protocol + rituximab* | R-CODOX-M/IVAC or R-hyper-CVAD |
| DLBCL | Burkitt-like therapy | R-CHOP × 6 |
| PMBCL | DA-EPOCH-R × 6 | DA-EPOCH-R × 6 |
| ALCL | ALCL 99 protocol† | CHOEP × 6 |
| . | Pediatric approach . | Adult approach . |
|---|---|---|
| HL | ||
| Stage I/II (non-bulky) | ABVE × 2-4 ± RT; VAMP × 4 ± RT; OEPA × 2 ± RT | ABVD × 4-6 with risk-adapted use of RT |
| Stage I/II (bulky) | ABVE-PC × 4 ± RT; OEPA × 2, plus COPDAC × 2 ± RT | ABVD × 4-6 plus RT in most cases |
| Stage III/IV | ABVE-PC × 4-5 plus RT in most cases; OEPA × 2, plus COPDAC × 4 ± RT | ABVD × 6 |
| BL | ||
| Low risk | COPAD × 2 | R-CODOX-M × 3, DA-EPOCH-R, or rituximab, or R-hyper-CVAD |
| High risk | FAB LMB96 protocol + rituximab* | R-CODOX-M/IVAC or R-hyper-CVAD |
| DLBCL | Burkitt-like therapy | R-CHOP × 6 |
| PMBCL | DA-EPOCH-R × 6 | DA-EPOCH-R × 6 |
| ALCL | ALCL 99 protocol† | CHOEP × 6 |
CHOEP, cyclophosphamide, doxorubicin, vincristine, etoposide, and prednisone; R-CODOX-M, rituximab plus cyclophosphamide, vincristine, and doxorubicin-methotrexate; R-CODOX-M/IVAC,rituximab plus cyclophosphamide, vincristine, and doxorubicin-methotrexate/ifosfamide, etoposide, and cytarabine; R-hyper-CVAD, rituximab plus hyper-CVAD.
R-CHOP (rituximab plus cyclophosphamide, vincristine, and prednisone) prophase → 2 cycles of induction with R-COPADM × 2 → 2 cycles of maintenance with rituximab plus CYM plus intrathecal chemotherapy.
Cyclophosphamide-dexamethasone prophase followed by 6 alternating cycles of course A (dexamethasone, high-dose methotrexate, ifosfamide, cytarabine, and etoposide) and course B (dexamethasone, high-dose methotrexate, cyclophosphamide, and doxorubicin) chemotherapy.