Protocol-Stipulated Dose Modification to Manage Chemotherapy-Induced Peripheral Neuropathy in Children, Adolescents, and Young Adults With High-Risk Hodgkin Lymphoma

Heneghan MB, Parsons SK, Keller FG, Renfro LA, Pei Q, Rodday AM, Wu Y, Punnett A, Belsky JA, Henderson TO, Kelly KM, Castellino SM. Protocol-Stipulated Dose Modification to Manage Chemotherapy-Induced Peripheral Neuropathy in Children, Adolescents, and Young Adults With High-Risk Hodgkin Lymphoma. JCO Oncol Pract. 2025 Apr;21(4):526-534. doi: 10.1200/OP.24.00089. Epub 2024 Sep 20. PMID: 39303168; PMCID: PMC11922787.

Brentuximab vedotin (BV) incorporation into frontline chemotherapy regimens improved outcomes for Hodgkin lymphoma (cHL). The shared mechanism of action of BV and vinca alkaloids as microtubulin inhibitors increased the potential risk of chemotherapy-induced peripheral neuropathy (CIPN). Rates of CIPN and use of protocol-stipulated dose modifications of a microtubulin inhibitor were examined on the Children’s Oncology Group AHOD1331 study, which compared BV, doxorubicin, vincristine (VCR), etoposide, prednisone, cyclophosphamide (BV-AVE-PC; BV arm) to bleomycin containing ABVE-PC (standard arm) in high-risk cHL patients ages 2–21 years.