Review Article
Refractory and Relapsed Hodgkin Lymphoma:
A Comprehensive Review of Biology and Recent Advances in Therapy
Adil Abdelhamed Abbas*
Issue:
Volume 11, Issue 4, December 2026
Pages:
84-98
Received:
4 August 2026
Accepted:
5 September 2026
Published:
15 October 2026
Abstract: HL accounts for nearly 3% of pediatric cancers. Compared to NLPHL, cHL primarily affects older children and adolescents. The risk-adapted, response-based management approach, which uses combined modality therapy, advances in modern imaging techniques, and careful use of consolidation RT, has led to steady improvements in EFS and OS, with current rates surpassing 90%. However, nearly 10–30% of patients may still experience resistant disease or relapse at different times. Achieving a second CR is generally difficult. Conventional CTR, HD CTR, and ABMT have been the main treatments for several decades. Advanced-stage (stage III and IV) R&R HL generally requires intensive treatment. Meanwhile, treatment for low-stage relapses (stage I and II) require a less intensive approach. The popularity of purely conventional CTR agents is decreasing. Combining one or more of the newer targeted medications, such as brentuximab vedotin, with conventional CTR, or utilizing pure targeted medications to induce second remission, has become standard practice. The treatment outcomes for R&R HL decline with each subsequent relapse. Second and third relapses usually result in much worse outcomes. Depending on the pattern and timing of relapse, the EFS after second-line treatment ranges from 10% to 50%. Many newly identified genetic mutations and molecular pathways are linked to the disease development and progression. Targeting these pathways may help cure patients who do not respond to current therapies. Allogeneic BMT may offer some assistance. The recently developed anti-CD30, CAR T-cell therapy shows promise, especially for patients with refractory disease and those experiencing frequent relapses. In this review, we discuss the mechanisms behind the disease's resistance to treatment and modern approaches to overcoming it.
Abstract: HL accounts for nearly 3% of pediatric cancers. Compared to NLPHL, cHL primarily affects older children and adolescents. The risk-adapted, response-based management approach, which uses combined modality therapy, advances in modern imaging techniques, and careful use of consolidation RT, has led to steady improvements in EFS and OS, with current ra...
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Research Article
Clinicopathological Spectrum of Cancer Among Patients Aged 1–25 Years in a Bangladeshi Tertiary Referral Hospital: Structured International Benchmarking
Issue:
Volume 11, Issue 4, December 2026
Pages:
99-118
Received:
7 October 2026
Accepted:
17 October 2026
Published:
31 October 2026
DOI:
10.11648/j.ijcocr.20261104.12
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Abstract: Cancer in children, adolescents, and young adults comprises a biologically and clinically heterogeneous spectrum. Evidence from Bangladesh is limited, and comparisons across studies are complicated by inconsistent age definitions, referral patterns, and cancer classification systems. This hospital based descriptive study included 105 patients aged 1-25 years with a documented malignant diagnosis at the oncology outpatient department of Rajshahi Medical College and Hospital. Age, sex, primary site, diagnostic category, and histopathology were summarized using counts, percentages, and 95% Wilson confidence intervals. A structured contextual search of peer-reviewed studies and authoritative datasets from Bangladesh, India, Nigeria, Europe, Japan, Korea, Australia, Ireland, the United States, France, Brazil, China, Jordan, WHO, and IARC was undertaken. External estimates were compared narratively and not pooled because of heterogeneity in age windows, settings, denominators, and classification systems. Of the patients, 83 (79.0%; 95% CI 70.3-85.7) were aged 15-25 years and 22 (21.0%; 95% CI 14.3-29.7) were aged 1-14 years; 52.4% (95% CI 42.9-61.7) were male. Sarcomas were the most frequent diagnostic group (26.7%; 95% CI 19.1-35.8), followed by germ cell tumors (21.9%; 95% CI 15.1-30.7), lymphomas (14.3%), and central nervous system tumors (12.4%). Bone/soft-tissue and gonadal sites comprised 52.4% of the cohort. Comparator datasets showed more hematologic, sarcoma, CNS, bone, and germ-cell malignancies in younger and referral populations, while older population-based datasets were increasingly dominated by epithelial cancers. The findings represent a tertiary hospital case mix rather than population incidence. Sarcoma and germ-cell predominance plausibly reflects the young age window and referral setting. Harmonized age definitions, ICD-O-based coding, age-stratified reporting, population-based registration, and prospective stage, treatment, and outcome data are needed in Bangladesh.
Abstract: Cancer in children, adolescents, and young adults comprises a biologically and clinically heterogeneous spectrum. Evidence from Bangladesh is limited, and comparisons across studies are complicated by inconsistent age definitions, referral patterns, and cancer classification systems. This hospital based descriptive study included 105 patients aged ...
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