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1159 Risk-Adapted Therapy with ABVD for Low- and Intermediate-Risk Patients and Oepa-Copdac for High Risk Patients Plus Involved-Field Radiation Therapy (IFRT) Based on Prognosis at Diagnosis and Early Response: Results from Pediatric Argentinian Collaborative Group Gatla Study for Children and Adolescents with Hodgkin Lymphoma

Program: Oral and Poster Abstracts
Session: 624. Hodgkin Lymphoma and T/NK Cell Lymphoma—Clinical Studies: Poster I
Hematology Disease Topics & Pathways:
Non-Biological, Diseases, Therapies, Hodgkin Lymphoma, Pediatric, chemotherapy, Study Population, Lymphoid Malignancies
Saturday, December 5, 2020, 7:00 AM-3:30 PM

David Alejandro Veron, MD1, Patricia Streitenberger, MD2*, Cecilia Riccheri, MD3*, Monica Matus, MD4*, Pedro Negri Aranguren, MD5*, Maria Alejandra Costa, MD6*, Nestor Alfredo Rossi, MD7*, Elizabeth Hiramatsu, MD8*, Maria Alejandra Cedola, MD9*, María Constanza Drozdowski, MD10*, Sandra Borchichi, MD11*, Marcelo Coirini, MD12*, María Cecilia Murray, MD13*, Karina D'Aloi, MD14*, Carlos Holmann, MD15*, Matilde Gomel, MD16*, Gisela Drago, MD17*, Horacio Daniel Caferri, MD18*, Maria Angelica Fernandez Barbieri, MD19*, Mara Villamil, MD20*, Claudia Mabel Ruiz, MD21*, Sandra Ethel Zirone, MD22* and Monica Makiya, MD23*

1GATLA Argentinian Collaborative Group, Pilar, ARG
2GATLA Argentinian Collaborative Group, Buenos Aires, Argentina
3GATLA Argentinian Collaborative Group, El Palomar, ARG
4GATLA Argentinian Collaborative Group, Rosario, SL, ARG
5GATLA Argentinian Collaborative Group, Paraná, Argentina
6GATLA Argentinian Collaborative Group, La Plata, ARG
7GATLA Argentinian Collaborative Group, Santa Fe, ARG
8GATLA Argentinian Collaborative Group, Córdoba, ARG
9GATLA Argentinian Collaborative Group, Neuquén, ARG
10GATLA Argentinian Collaborative Group, Neuquén, Argentina
11GATLA Argentinian Collaborative Group, Posadas, ARG
12GATLA Argentinian Collaborative Group, Rosario, Argentina
13GATLA Argentinian Collaborative Group, Mar del Plata, Argentina
14GATLA Argentininan Collaborative Group, Buenos Aires, ARG
15GATLA Argentinian Collaborative Group, Córdoba, Argentina
16GATLA Argentinian Collaborative Group, Resistencia, Argentina
17GATLA Argentinian Collaborative Group, Mendoza, Argentina
18GATLA Argentinian Collaborative Group, Bahia Blanca, ARG
19GATLA Argentinian Collaborative Group, San Isidro, Argentina
20GATLA Argentinian Collaborative Group, San Justo, Argentina
21GATLA Argentinian Collaborative Group, La Plata, Argentina
22GATLA Argentinian Collaborative Group, Rosario, ARG
23GATLA Argentinian Collaborative Group, Buenos Aires, CH, ARG

Background: The GATLA Collaborative Group has a 50 year (y) long experience of running cooperative trials for lymphomas in Argentina.

Aim: Describe the outcome of pediatric patients(pts) treated according to the international cooperative work with AHOPCA and St. Jude Children's Research Hospital (11-EHP-12) adopting OEPA/COPDAC strategy for High Risk (HR) pts and ABVD for Intermediate (IR) and Low Risk (LR) pts.

Methods: 11-EHP-12: Risk assignment according Stanford/Danna Farber/ SJCRH Consortium classification. LR: ABVD x 4± IFRT (20 Gy). IR: ABVD x 6 ± IFRT (20 Gy). HR: OEPA-COPDAC+IFRT (20/25 Gy). Response evaluation: LR after 4th cycle, IR and HR after the 2nd cycle. Complete Remission (CR): response > 80% reduction and PET negative. Partial Remission (PR): response >50% and <80% reduction and/or PET positive. 170 pediatric patients (pts) were enrolled since November 2012. 133 evaluable pts. 37 on treatment and/or a follow up of less than 5 years. Sex: M/F: 85 (63,9%) /48. Median age: 13 y (range 4-18 y). Histology: nodular sclerosis 91 (68,4%), mixed celularity 31 (23.3%), lymphocyte rich 1 (0,7%), lymphocyte depleted 1 (0,7%), nodular lymphocyte predominant 8 (6,9%). Stage: I :16 (12%), II: 51 (38.4%), III: 27 (20.3%), IV: 39 (29.3%). B Symptoms: 66 (49.6%). Interim evaluation: PET/TC: 109/133 (82%), TC: 24. Distribution by risk groups: HR pts.: 77 (57,9%), IR: 35 (26,3%), LR: 21 (15,8%).

Results: 5 y OS was 94% ( 100% for LR and IR, and 91% HR) and 5y EFS was 88% (100% for LR, 91% IR, and 84% HR). 95% of the LR pts and 72% of the IR pts did not undergo radiotherapy. 70% of the HR pts achieved CR after the 2nd OEPA and received 20 Gy IFRT. According PR or CR after 2nd OEPA, the 5y EFS in HR pts was 84% and 90% respectively.

Conclusion: Thanks to this international cooperation We could significantly improve the results in Argentina compared to our previous experience (7-PHD-96: COPP-ABV x 6 + IFRT Bulky disease or PR (20/25Gy): 5yOS:85%, 5yEFS:67%), reduce the number of patients who required radiotherapy and reproduce the Euronet experience for HR pts in a different context.

Disclosures: No relevant conflicts of interest to declare.

*signifies non-member of ASH