The results of the programs of the combined treatment for Hodgkin's lymphoma according to the protocol DAL-HD-90 depending on the age

The great progress in the treatment for Hodgkin’s lymphoma was achieved by the DAL-HD group in the 1980-90s, and the principles of that protocol are being used and improved till now. The data presented by us show that the protocol DAL-HD is the most effective in children younger than 10 years. At the same time multifactor analysis has demonstrated, that the relapses are 2,4 times more frequent in adolescent males (10-14 years old) with initial symptoms of intoxication than in younger patients, relapse-free survival in that group drops to 50-70% level, and their mortality rate is 1,8 times higher, but without significant differences in overall survival. Probably, chemotherapy should be intensified in that age group (10-14 years) like in the modern programs of treatment for Hodgkin’s lymphoma in adults, which have achieved excellent results. According to our analysis, the survival data in the age group older than 15 are satisfactory (5-year relapse-free survival 70-80%, overall survival 90-95%). Reduction of irradiation volumes and of its total dose is the inherent feature of the modern combined treatment for Hodgkin’s lymphoma. Involved-field radiation therapy seems to be adequate, and in children up to 9 years of age programs of more local irradiation should be wider implemented to reduce the risk of late complications. The results presented by us will probably lead to development of more effective programs of combined treatment for Hodgkin’s lymphoma in children and adolescents.