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CA Cancer J Clin. 2018 Mar;68(2):116-132. doi: 10.3322/caac.21438. Epub 2017 Dec 1.

Hodgkin lymphoma: A review and update on recent progress.

Author information

1
Assistant Professor of Medicine, Departments of Medicine and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.
2
Director, Division of Hematologic Malignancies and Professor of Oncology, Departments of Medicine and Oncology, Johns Hopkins University School of Medicine, Baltimore, MD.

Abstract

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.

KEYWORDS:

Hodgkin lymphoma; allogeneic stem cell transplantation; antibody-drug conjugate; brentuximab; immunotherapy; positron emission tomography (PET)-adapted therapy; programmed death 1 (PD-1) inhibitor

PMID:
29194581
PMCID:
PMC5842098
[Available on 2019-03-01]
DOI:
10.3322/caac.21438
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