• Event free survival which is the time from treatment start to the time of the first failure (disease recurrence, second malignancy or death). [ Time Frame: 7-8 years ] [ Designated as safety issue: Yes ]
  

Treatment Plan Description:

Adriamycin 25 mg/m2 IV Day 1 of weeks 1, 3, 5, 7, 9, 11

Vinblastine 6 mg/m2 IV Day 1 of weeks 1, 3, 5, 7, 9, 11

Nitrogen mustard 6 mg/m2 IV Day 1 of weeks 1, 5, 9

Vincristine 1.4 mg/m2 IV Day 1 of weeks 2, 4, 6, 8, 10, 12

Bleomycin 5 units/m2 IV Day 1 of weeks 2, 4, 6, 8, 10, 12

Etoposide 60 mg/m2 IV Days 1,2 of weeks 3, 7, 11

Prednisone* 40 mg/m2/day divided in 3 doses PO Every other day of weeks 1-12

G-CSF (only as needed in case of severe myelo-suppression requiring treatment delay) 5 mcg/kg SC Days 3-13, 16-26, 29-39, 42-52, 55-65, 68-78 (as clinically indicated)

* Prednisone taper is foreseen for the last 2 weeks of therapy. Patients will be treated with 12 weeks of Stanford V chemotherapy in the schedule outlined above. Patients will then receive radiation therapy after completion of 12 weeks of chemotherapy. The radiation dose to individual nodal sties will be based on response after 8 weeks of chemotherapy: 15 Gy for patients achieving a complete response and 25.5 Gy achieving less than a complete response, or patients with bulky mediastinal mass.

Inclusion Criteria:

• Patient is less than or equal to 21 years of age
• Patient has a confirmed diagnosis of previously untreated Hodgkin lymphoma
• Has Ann Arbor stage IB, IIIA, or IA/IIA with extramedullary involvement, multiple nodal involvement (3 or more sites), or bulky mediastinal adenopathy.

Exclusion Criteria:

• Patients with favorable risk features
• Patients with unfavorable risk features
• Patients who have received prior therapy for Hodgkin's disease.