Interpretation of the updated key points of the 2021 CSCO Children and Adolescent Lymphoma Guidelines

In order to actively promote the development of clinical oncology in my country, improve the clinical and scientific research level of clinical oncologists, and further promote the formulation and promotion of CSCO guidelines for diagnosis and treatment, the Chinese Society of Clinical Oncology (CSCO) held a meeting in Beijing on April 23-24, 2021.
The 2021 CSCO Guidelines Conference will be held in a combination of online and offline methods.

At this meeting, Professor Zhang Yizhu from the Cancer Center of Sun Yat-Sen University interpreted the update points of the "CSCO Children and Adolescent Lymphoma Guide (2021 Edition)".
Yimaitong organized the main content as follows.

The incidence of lymphoma in children and adolescents is relatively low, and the research progress is relatively small.
The content of this update is not much, mainly focusing on Hodgkin's lymphoma (HL) and anaplastic large cell lymphoma (ALCL).

Mature B-cell lymphoma and lymphoblastic lymphoma have not been updated in this guide due to no significant progress recently.

 Studies related to Hodgkin’s lymphoma have shown that the IGEV regimen (ifosphate, gemcitabine, vinorelbine, and prednisolone) has an overall effective rate (ORR) of 81.
3% for salvage treatment.
This regimen has been widely used in the past 5 years.
And it has the potential to mobilize stem cells with high efficiency and low toxicity.

Based on the results of this study, the 2021 version of the CSCO Children and Adolescent Lymphoma Guidelines recommends this program as a level II recommendation in the part of relapsed or refractory (R/R) HL.

 The 2020 European EuroNet Collaborative Group Guidelines emphasize the prognostic value of PET-CT for patients with R/R classic Hodgkin lymphoma (cHL) after chemotherapy.
The 2021 version of the CSCO Children and Adolescent Lymphoma Guidelines has this in the notes.
Update.The European EuroNet Collaborative Group’s guidelines provide risk stratification and recommendations for R/R cHL in children and adolescents based on the efficacy evaluation of PET2 (first-line conventional dose rescue plan after 2 courses) and PET4 (2-line conventional dose rescue plan after 2 courses).
The rescue plan can also guide the follow-up treatment plan for children with R/R cHL.

This update of the guide also includes relevant content.

In addition, the European EuroNET collaborative group guidelines also pointed out that proton therapy has a low cumulative dose to vital organs, which can reduce the long-term side effects of children and adolescents, and is suitable for patients who have failed first-line radiotherapy.

This update of the guide also includes relevant content.

 Anaplastic large cell lymphoma 2021 edition of "CSCO Children and Adolescent Lymphoma Guidelines" has supplemented the residual lesions of ALCL (<25%-30% of the primary lesion), and added the risk group in the part of children with recurrence And the specific definition (high risk: recurrence time <1 year after discontinuation, CD3 positive or previous use of vinblastine; low risk: relapse time> 1 year after discontinuation, CD3 negative and no previous use of vinblastine).

 According to relevant research reports, the 5-year event-free survival rate of children with low-risk relapses with vinblastine monotherapy for 24 months can reach 81%.

In this update of the guideline, in the part of relapsed and refractory ALCL, vinblastine was changed from a level II recommendation to a level I recommendation.

 Relevant case reports show that vinorelbine alone can relieve children with relapses.

In this guideline update, vinorelbine is included in the level III recommendation in the part of relapsed and refractory ALCL.

 Poke "read the original text" and we will make progress together