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Treatment of relapsed or refractory classical Hodgkin lymphoma

Author
Ann S LaCasce, MD
Section Editors
George P Canellos, MD
Arnold S Freedman, MD
Deputy Editor
Alan G Rosmarin, MD

INTRODUCTION

Most patients with Hodgkin lymphoma (HL; formerly called Hodgkin's disease) will attain a complete remission after initial treatment and achieve long-term disease control (ie, cure). However, relapse may occur in 10 to 15 percent of patients with favorable prognosis early (stages I to II) HL and in 15 to 30 percent of patients with more advanced HL [1-7]. Approximately 10 to 15 percent of patients have refractory disease that either does not respond to initial therapy or progresses after an initial partial response.

The goal of treatment of relapsed or refractory HL should be to achieve long-term disease control while limiting toxicity and complications of therapy. Salvage chemotherapy can achieve a complete response in more than half of patients with first relapse of HL or refractory disease, but long-term disease-free survival generally requires autologous hematopoietic cell transplantation (HCT). (See "Determining eligibility for autologous hematopoietic cell transplantation".)

Treatment of relapsed/refractory HL with chemotherapy, radiation therapy, and immunotherapy will be reviewed here. The role of HCT in HL is described separately. (See "Hematopoietic cell transplantation in classical Hodgkin lymphoma".)

DEFINITIONS

In this discussion, the following definitions will apply:

Relapse (or recurrence) is the reappearance of disease at sites of prior disease and/or at new sites after achievement of complete response (CR).

                             

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Literature review current through: May 2017. | This topic last updated: May 15, 2017.
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