The evolution of treatment for pediatric advanced stage classic Hodgkin lymphoma - a narrative literature review.

Recent trials introducing novel immunotherapy into the treatment of advanced-stage pediatric classic Hodgkin lymphoma (cHL) suggest that cure rates will exceed 90%. Consequently, more than ever there is a need to minimize the toxicity of treatment and ensure that survivors experience a quality of life unimpaired by late effects. We performed a structured literature review to analyze frontline trials of advanced pediatric cHL, the impact of toxicity of treatments and on health-related quality of life. A total of 6 clinical trials were included, 4 randomized phase 3 trials, 1 non-randomized phase 3 trial and 1 phase 2 trial. One longitudinal study and 5 retrospective registry-based studies were included in the health-related quality of life review. The use of novel systemic treatments has significantly improved outcomes in advanced- pediatric cHL. However, new challenges arise to better understand quality of life outcomes among survivors, and to make new drugs more widely accessible.