Hodgkin Lymphoma : Treatment
Treatment of Hodgkin Lymphoma: Involved field radiotherapy and multimodality chemotherapy are highly effective in treating classic Hodgkin lymphoma (cHL). The overall cure rate is about 90% for stage I and IIA. For advanced stages (IVA & IVB), the 5-yr disease-free survival is 60% to 70%. Persistent disease or early relapses are treated with high-dose chemotherapy followed by autologous stem cell transplantation. Long-term survivors of cHL who are treated with radiation or alkylating agents are at a significantly higher risk of developing secondary malignancies, including acute non-lymphocytic leukemias, non-Hodgkin lymphomas (usually diffuse large B-cell lymphomas), and solid cancers (colon, breast, lung, and melanoma). Secondary malignancies are the main cause of death in cHL survivors. The current regimens minimize the use of radiation, contain less toxic agents, and are still able to achieve satisfactory results. Newer agents that have proven highly effective in patients with refractory disease include: anti-CD30 antibody conjugate brentuximab vedotin and immune checkpoint inhibitors that block PD-1, the receptor for PDL1 & PDL2 expressed on the surface of RS cells.