Abstract P096

International Harmonization Efforts for Pediatric, Adolescent and Young Adult Hodgkin Lymphoma: A Current Report from the SEARCH FOR CAYAHL Group

Background: Initial evaluation and staging of patients with Hodgkin lymphoma (HL) provides the foundation for risk-adapted treatment. The Ann Arbor staging system, and subsequently the Cotswolds modification criteria, help classify patients into risk groups according to the distribution and number of anatomic sites of disease. As imaging techniques advance, ongoing refinements to staging in HL are necessary to improve prognostication and risk group assignment. Currently published staging systems are not reflective of current pediatric practices, and some elements of staging and response criteria differ across pediatric consortia. Harmonization of staging and response assessment criteria in pediatric HL is imperative to facilitate cross-trial comparison of clinical studies globally.

Methods: Established in 2011 with harmonization as its goal, the international SEARCH (Staging, Evaluation and Response Criteria Harmonization) for CAYAHL (Childhood, Adolescent and Young Adult Hodgkin Lymphoma) group is comprised of more than 40 expert members across 6 countries, with representatives from the Children’s Oncology Group, European Network for Pediatric HL, Pediatric Hodgkin Consortium, and the Latin American Hemato Oncologic Pediatric Diseases Consortium. Utilizing clinical data across consortium groups where available, and delphi consensus methods where data is lacking, SEARCH has proceeded with harmonization efforts across multiple areas of HL staging and response assessment.

Results: Through SEARCH’s working groups, we published harmonization projects for the involvement of liver, cortical bone, Waldeyer’s Ring and E-lesions to date. In 2023/24, harmonization efforts were completed for CNS involvement and lung lesions with manuscripts in submission. A manuscript for a harmonized staging atlas for pediatric HL is also under current review.

Conclusions: We present an update on the efforts of the international SEARCH for CAYAHL group. SEARCH has successfully completed the majority of our initial harmonization projects, with next steps to include publication of a comprehensive review of current practices. The updated Lugano 2014 publication does not include pediatric patients. Given the peak age of patients with HL within the AYA spectrum and given that care is often shared between the adult and pediatric groups, there is a pressing need for pediatric oncology input and collaboration into future updates to HL staging and response assessment criteria.