Hodgkin’s disease is a cancer of the lymphatic system, a network of thin vessels and glands located all over the body. The system is involved in fighting infection. Survival rates for children with Hodgkin’s disease have improved greatly in the past 25–30 years. Most patients who receive treatment will have a long-term remission (disease-free state). However, some side effects of treatment can occur more than 10 years after treatment (late effects). They can include heart, lung, and thyroid problems; sterility (inability to have children); and second cancers.

Researchers are studying ways to maintain current survival rates and to reduce late effects of therapy. In the past, treatment for Hodgkin’s disease included high doses of anti-cancer fighting drugs. Some caused patients to become sterile, to develop leukemia, or to develop heart problems. Past treatments also used higher doses of radiation therapy. In some cases, the radiation caused growth problems in patients. It also put them at higher risk for heart disease and second cancers as they aged. This study will test whether new combinations of drugs can decrease the long-term side effects. The study will also test lower doses of radiation therapy. Study subjects will be assigned to treatment based on several risk factors which can affect how well each subject responds to treatment. The risk group is decided on the basis of how large or “bulky” the lymph glands have grown, how much the cancer has spread (stage), and whether symptoms like fever, sweat, or weight loss are present. In this study, patients will be placed in one of three risk groups. Lower doses of chemotherapy and radiation therapy will be given to patients in the lower risk groups.

Inclusion Criteria:

• Histologically confirmed, previously untreated Hodgkin’s disease (Patients receiving limited emergent radiation therapy or steroid therapy because of cardiopulmonary decompensation or spinal cord compression will be eligible for protocol enrollment).
• Age: 21 years of age or younger
• Stage: Ann Arbor stages
• No prior treatment
• No pregnant or nursing women

Exclusion Criteria:

• Pregnant or nursing women