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Treatment of relapse of classical Hodgkin lymphoma after initial chemotherapy

INTRODUCTION

Most patients with Hodgkin lymphoma (formerly called Hodgkin's disease) will attain a remission after induction chemotherapy with or without radiation therapy. However, relapse rates range from 10 to 20 percent in favorable prognosis localized (stage I-II) disease [1] to 30 to 40 percent in patients with more advanced disease [2-6]. In addition, approximately 10 to 15 percent of patients experience progression of disease after a partial initial response.

Salvage therapy with second (or third) line regimens can achieve responses in approximately 50 percent of these patients, although long-term disease-free survival following the treatment of relapse with chemotherapy alone is less common. Selected patients with poor prognosis after first relapse, patients with a second relapse, and patients with progressive disease are candidates for high dose chemotherapy followed by hematopoietic cell transplantation. (See "Hematopoietic cell transplantation in classical Hodgkin lymphoma" and "Second and third line chemotherapy regimens and biologic therapy for relapsing or resistant classical Hodgkin lymphoma".)

In this discussion, the following definitions will apply:

Relapse (or recurrence) is the reappearance of disease in sites of prior disease and/or in new sites after initial therapy and attainment of complete response (CR).

Progression refers to increasing evidence of disease after achieving a stable partial remission.

                    

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Literature review current through: Mar 2014. | This topic last updated: Mar 17, 2014.
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