Appel et al identified pediatric patients with low-risk lymphocyte-predominant Hodgkin's lymphoma (LPHL) who can be managed with minimal therapy. This can avoid late toxicities from chemotherapy or radiation. The authors are from multiple hospitals and universities in the United States and Canada.


Features of a patient with Hodgkin's disease who can undergo minimal treatment:

(1) age < 22 years

(2) lymphocyte predominant Hodgkin's disease (LPHL)

(3) stage IA or IIA

(4) absence of B symptoms

(5) absence of bulky disease (nodal aggregate > 6 cm in diameter, mediastinal mass greater than one third of the thoracic diameter)

Status at Diagnosis

Initial Therapy

Less Than Complete Response

single lymph node


AV-PC with or without IFRT


3 cycles AV-PC chemotherapy




• AV-PC is doxorubicin (Adriamycin), vincristine, prednisone and cyclophosphamide

• IFRT is involved field radiation therapy.


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