Hodgkin disease/lymphoma

Abstract

The management of HL continues to evolve. Major changes have been incorporated into these guidelines since inception. Current management of HL involves initial treatment with chemotherapy or combined modality therapy, followed by restaging to assess treatment response. PET scans are recommended to evaluate initial staging and assess treatment response at restaging. However, they are not recommended for routine surveillance. Combined modality therapy (brief course of chemotherapy and limited irradiation) is the preferred treatment for early-stage favorable CHL (stage IA-IIA nonbulky) and early-stage unfavorable CHL (stage I-II bulky). Chemotherapy alone or combined modality therapy is recommended for advanced-stage CHL (stage IB-IIB nonbulky and stage III-IV). Combined modality therapy or radiation alone is the option for early-stage LPHL. Patients with advanced-stage LPHL may be treated with more aggressive therapy. The role of chemotherapy or antibody-based therapy is being explored in ongoing clinical trials for early-and advanced-stage LPHL. HDT/ASCR is the best treatment option for patients with relapsed or refractory HL, although it does not improve overall survival. Consistent with NCCN philosophy, participation in clinical trials is always encouraged. HL is now curable in most patients because more effective, less toxic regimens have been introduced. However, survivors may experience late treatment-related side effects. For this reason, long-term follow-up by an oncologist is essential after completion of treatment. Counseling about survivorship issues and careful monitoring for late treatment-related side effects should be integral follow-up for these patients. © Journal of the National Comprehensive Cancer Network.

Publication Title

JNCCN Journal of the National Comprehensive Cancer Network

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