TY - JOUR
T1 - Hodgkin lymphoma
T2 - A review and update on recent progress
AU - Shanbhag, Satish
AU - Ambinder, Richard F.
N1 - Funding Information:
Corresponding author: Richard F. Ambinder, MD, PhD, Johns Hopkins University School of Medicine, 389 CRB1, 1650 Orleans St, Baltimore, MD 21287; rambind1@jhmi.edu DISCLOSURES: This study was supported by National Institutes of Health grant P30CA006973. Richard F. Ambinder reports personal fees from Bristol-Myers Squib and Celgene outside the submitted work. Satish P. Shanbhag made no disclosures.
Publisher Copyright:
© 2017 American Cancer Society.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Hodgkin lymphoma (HL) is a unique hematopoietic neoplasm characterized by cancerous Reed-Sternberg cells in an inflammatory background. Patients are commonly diagnosed with HL in their 20s and 30s, and they present with supradiaphragmatic lymphadenopathy, often with systemic B symptoms. Even in advanced-stage disease, HL is highly curable with combination chemotherapy, radiation, or combined-modality treatment. Although the same doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapeutic regimen has been the mainstay of therapy over the last 30 years, risk-adapted approaches have helped de-escalate therapy in low-risk patients while intensifying treatment for higher risk patients. Even patients who are not cured with initial therapy can often be salvaged with alternate chemotherapy combinations, the novel antibody-drug conjugate brentuximab, or high-dose autologous or allogeneic hematopoietic stem cell transplantation. The programmed death-1 inhibitors nivolumab and pembrolizumab have both demonstrated high response rates and durable remissions in patients with relapsed/refractory HL. Alternate donor sources and reduced-intensity conditioning have made allogeneic hematopoietic stem cell transplantation a viable option for more patients. Future research will look to integrate novel strategies into earlier lines of therapy to improve the HL cure rate and minimize long-term treatment toxicities. CA Cancer J Clin 2018;68:116-132.
AB - Hodgkin lymphoma (HL) is a unique hematopoietic neoplasm characterized by cancerous Reed-Sternberg cells in an inflammatory background. Patients are commonly diagnosed with HL in their 20s and 30s, and they present with supradiaphragmatic lymphadenopathy, often with systemic B symptoms. Even in advanced-stage disease, HL is highly curable with combination chemotherapy, radiation, or combined-modality treatment. Although the same doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapeutic regimen has been the mainstay of therapy over the last 30 years, risk-adapted approaches have helped de-escalate therapy in low-risk patients while intensifying treatment for higher risk patients. Even patients who are not cured with initial therapy can often be salvaged with alternate chemotherapy combinations, the novel antibody-drug conjugate brentuximab, or high-dose autologous or allogeneic hematopoietic stem cell transplantation. The programmed death-1 inhibitors nivolumab and pembrolizumab have both demonstrated high response rates and durable remissions in patients with relapsed/refractory HL. Alternate donor sources and reduced-intensity conditioning have made allogeneic hematopoietic stem cell transplantation a viable option for more patients. Future research will look to integrate novel strategies into earlier lines of therapy to improve the HL cure rate and minimize long-term treatment toxicities. CA Cancer J Clin 2018;68:116-132.
KW - Hodgkin lymphoma
KW - allogeneic stem cell transplantation
KW - antibody-drug conjugate
KW - brentuximab
KW - immunotherapy
KW - positron emission tomography (PET)-adapted therapy
KW - programmed death 1 (PD-1) inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85043348659&partnerID=8YFLogxK
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U2 - 10.3322/caac.21438
DO - 10.3322/caac.21438
M3 - Review article
C2 - 29194581
AN - SCOPUS:85043348659
SN - 0007-9235
VL - 68
SP - 116
EP - 132
JO - CA Cancer Journal for Clinicians
JF - CA Cancer Journal for Clinicians
IS - 2
ER -