Background: Hodgkin's lymphoma (HL) is a highly curable malignant disease. Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life. Objectives: To assess the outcome of the HL patients treated with risk-adapted therapy approach at pediatric oncology department in South Egypt Cancer Institute and to assess the prognostic factors of survival in pediatric HL patients. Methods: This prospective study was carried out from January 2009 to January 2014, with median follow up of 36.5 months (range 8-58 months). Thirty four patients were eligible for this study stratified into three risk groups:low risk (LR), intermediate risk (IMR) and high risk (HR). Patients treated with two, four and six cycles respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved partial response. Results: Six patients were LR, 18 patients were IMR and 10 patients were HR. Six patients had events, progressive disease in 3 patients, relapse in 2 patients, and death in one patient due to fever neutropenia. The 3-years overall survival (OS) and event free survival (EFS) rates (± SE) were 91.2% ± 5.3% and 82.3% ± 7.3% respectively. Multivariate analysis revealed "B" symptoms and anemia were the significant independent factors for inferior EFS, however, hypoalbuminemia and anemia were the significant independent factor for lower OS. Conclusion: Risk-adapted combined-modality therapy with ABVD/COEP and involved-field radiation therapy has high efficacy and minimal toxicity in the treatment of pediatric HL.
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