Advanced Stage Hodgkin Lymphoma: Patient Management
Keywords:
Hodgkin Lymphoma, advanced stage, first-line treatmentAbstract
Hodgkin lymphoma (HL) is a rare cancer of the lymphoid system. It clinically presents with swollen lymph nodes and/or systemic symptoms, such as fever, night sweats, or weight loss, as signs of a more advanced stage disease. For the purpose of treatment allocation, HL cases are classified as early-stage favorable, early-stage unfavorable, and advanced-stage disease. Here below we describe four different clinical cases from real life that address some key issues and medical needs that are present in the daily practice with patients affected by advanced stage HL. The four clinical cases are quite heterogeneous, but in each case there are strong inputs to manage a specific category of advanced phase HL patient that is going to be treated with first-line therapy.
References
2. Santoro A, Magagnoli M, Spina M et al. Ifosfamide, gemcitabine, and vi- norelbine: a new induction regimen for refractory and relapsed Hodgkin’s lymphoma. Haematologica. 2007 Jan;92(1):35-41
3. Zinzani PL, Broccoli A, Gioia DM et al. Interim Positron Emission Tomography Response-Adapted Therapy in Advanced-Stage Hodgkin Lymphoma: Final Results of the Phase II Part of the HD0801 Study. J Clin Oncol. 2016 Apr 20;34(12):1376-85
4. Johnson P, Federico M, Kirkwood A et al. Adapted Treatment Guid- ed by Interim PET-CT Scan in Advanced Hodgkin›s Lymphoma. N Engl J Med. 2016; 374: 2419-2429
5. Hutchings M, Mikhaeel NG, Fields PA, Nunan T, Timothy AR. Prog- nostic value of interim FDGPET after two or three cycles of chemo- therapy in Hodgkin lymphoma. Ann Oncol. 2005;16(7): 1160-1168.
6. Hutchings M, Loft A, Hansen M, et al. FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood. 2006;107(1):52-59.
7. Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the Interna- tional Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol. 2014;32(27):3048-3058.
8. Gallamini A, Hutchings M, Rigacci L, et al. Early interim 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is prognosti- cally superior to international prognostic score in advanced-stage Hodg- kin’s lymphoma: a report from a joint Italian Danish study. J Clin Oncol. 2007;25(24): 3746-3752.
9. Press OW, Li H, Schöder H, et al; US Intergroup Trial of Response- Adapted Therapy for Stage III to IV Hodgkin Lymphoma Using Early Interim Fluorodeoxyglucose-Positron Emission Tomography Imaging: Southwest Oncology Group S0816.
10. Gallamini A, Tarella C, Viviani S, Romano A, Cimminiello M, Gini G., Rambaldi A., et al; Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed To- mography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial. J Clin Oncol. 2018 Feb 10;36(5):454-462. doi: 10.1200/JCO.2017.75.2543. Epub 2018 Jan 23.
11. Younes A, Bartlett NL, Leonard JP, et al. Brentuximab vedotin (SGN-
35) for relapsed CD30-positive lymphomas. N Engl J Med. 2010; 363(19):1812-1821.
12. Younes A, Gopal AK, Smith SE, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodg- kin’s lymphoma. J Clin Oncol. 2012;30(18):2183-2189.
13. Younes A, Connors JM, Park SI, et al. Brentuximab vedotin combined with ABVD or AVD for patients with newly diagnosed Hodgkin’s lymphoma: a phase 1, open-label, doseescalation study. Lancet Oncol. 2013;14(13): 1348-1356.
14. Moskowitz CH, Michot J, Martinelli G, et al. PD-1 Blockade with the Monoclonal Antibody Pembrolizumab (MK-3475) in Patients with Classical Hodgkin Lymphoma after Brentuximab Vedotin Failure: Pre- liminary Results from a Phase 1b Study [abstract]. Blood. 2014;124(21). Abstract 290.
15. Armand PA, Lesokhin AM, Halwani A, et al. Nivolumab in Patients with Relapsed or Refractory Hodgkin
16. Johnston PB, Inwards DJ, Colgan JP, et al. A Phase II trial of the oral mTOR inhibitor everolimus in relapsed Hodgkin lymphoma. Am J He- matol. 2010;85(5):320-324.
17. Townsend W, Linch D. Hodgkin’s lymphoma in adults. Lancet. 2012;380(9844):836-847.
18. Josting A, Rudolph C, Mapara M, et al. Cologne high-dose sequential chemotherapy in relapsed and refractory Hodgkin lymphoma: results of a large multicenter study of the German Hodgkin Lymphoma Study Group (GHSG). Ann Oncol. 2005;16(1):116-123.
19. Josting A, Müller H, Borchmann P, et al. Dose intensity of chemo- therapy in patients with relapsed Hodgkin’s lymphoma. J Clin Oncol. 2010;28(34):5074-5080.
20. Linch DC, Winfield D, Goldstone AH, et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resist- ant Hodgkin’s disease: results of a BNLI randomised trial. Lancet. 1993;341(8852):1051-1054.
21. Schmitz N, Pfistner B, Sextro M, et al; German Hodgkin’s Lymphoma Study Group; Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. Aggressive conventional chemo- therapy compared with high-dose chemotherapy with autologous hae- mopoietic stem-cell transplantation for relapsed chemosensitive Hodg- kin’s disease: a randomised trial. Lancet. 2002;359(9323): 2065-2071
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
