Treatment of relapsed and refractory Hodgkin Lymphoma

Semin Hematol. 2016 Jul;53(3):180-5. doi: 10.1053/j.seminhematol.2016.05.010. Epub 2016 May 12.

Abstract

Despite the high first-line cure rates in patients with Hodgkin Lymphoma (HL) still 10%-20% of patients suffer from relapsed or refractory disease. High-dose chemotherapy (HDCT) followed by autologous stem cell transplant (ASCT) is standard of care for suitable patients with relapsed or refractory HL and allows for cure in approximately 50%. Due to the poor prognosis of high-risk patients even with HDCT and ASCT, consolidation strategies have been evaluated to improve the cure rates. For patients with recurrence after HDCT and ASCT, treatment is palliative in most cases. The anti-CD30 antibody-drug conjugate brentuximab vedotin (BV) has been shown to induce high response rates in these patients; however, durable responses were reported in a small percentage of patients only. For carefully selected patients with multiple relapses, dose-reduced allogeneic transplant (RICallo) is a potentially curative option. The role of RICallo will have to be re-evaluated in the era of anti-programmed death-1 (PD1) antibodies.

Keywords: Autologous stem cell transplant; Brentuximab vedotin; High-dose chemotherapy; Hodgkin lymphoma; Relapse.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Clinical Trials as Topic
  • Hematopoietic Stem Cell Transplantation
  • Hodgkin Disease / diagnosis
  • Hodgkin Disease / therapy*
  • Humans
  • Recurrence
  • Salvage Therapy

Substances

  • Antineoplastic Agents