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Hodgkin LymphomaModern Management of Children and Young Adults

Hodgkin lymphoma (HL) is the most common cancer in adolescence and represents 15% of all cases of cancer in children and adolescents. In three decades, HL has become a highly curable lymphoid malignancy with an expected survival rate at ten years of around 90–93%. Further refinements of treatment strategy are needed in order to improve treatment results in relapsed and refractory patients and to reduce long-term morbidity of therapy, mainly secondary malignancies, cardiovascular early morbidity, and impaired fertility. Progress in imaging definition of involvement based on fluorodeoxyglucose-positron emission tomography (FDG-PET)/computed tomography (CT) and response-adapted strategy based on FDG-PET/CT intermediate evaluation has led to a reduction of radiotherapy. Procarbazine-free chemotherapy regimens with moderate anthracyclin dose will further reduce the risk of treatment’s sequelae. Recent advances in the understanding of the biology of HL have demonstrated, with promising results, the link between immune system control and Hodgkin lymphoma pathogenesis, opening the road to new treatments in relapsed and refractory patients based on targeted monoclonal antibodies.