Currently children and adolescents diagnosed with Hodgkin lymphoma have 5-year overall survival rates greater than 90%.1,2 Therapeutic approaches to Hodgkin lymphoma have evolved, from high-dose extended-field radiation to dose-intensive combination chemotherapy regimens (which relied heavily on alkylating agent exposure), to the current standard of care for all stages of disease in children using multiagent chemotherapy combined with low-dose involved field radiation therapy (IFRT).1 This evolution has been driven by recognition that these curative regimens have been accompanied by significant late treatment–related complications, including secondary malignancies, cardiovascular disease, pulmonary fibrosis, thyroid dysfunction, and gonadal toxicity.2- 4 These late effects significantly influence the quality of life for survivors of Hodgkin lymphoma.
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