Current treatment and immunotherapy of Hodgkin's lymphoma.
The treatment of Hodgkin's lymphoma has changed significantly over the last decades, rendering this entity one of the most curable human cancers. To date, about 80% of patients achieve long-term disease-free survival. Current strategies in first-line treatment aim at further improving outcome and thereby preventing therapy-induced complications, such as infertility, cardiopulmonary toxicity, and secondary malignancies. Ongoing trials for patients in early stages are investigating lower radiation doses and smaller radiation fields and possible reductions in the doses or number of cycles of chemotherapy given. For patients in advanced stages, new drug combinations with higher dose density and intensity have been developed, and are currently being evaluated in clinical trials. Approaches for relapsed Hodgkin's lymphoma comprise salvage radiotherapy, salvage chemotherapy and high-dose chemotherapy followed by autologous stem cell transplantation. In recent years, the introduction of effective salvage high-dose therapy and a better understanding of prognostic factors have remarkably improved the management of relapsed Hodgkin's lymphoma. For multiple pretreated patients antibody-based agents that showed promising results in experimental models are being investigated in clinical trials. Radioimmunoconjugates and monoclonal antibodies have demonstrated some clinical efficacy. Here, we review new aspects in the treatment of primary and relapsed Hodgkin's lymphoma as well as recent immunotherapeutic approaches.
Klimm
Beate
B
Department I of Internal Medicine, University Hospital Cologne, 50924 Cologne, Germany. beate.klimm@uk-koeln.de
Schnell
Roland
R
Diehl
Volker
V
Engert
Andreas
A
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019090:Case Management; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005293:Ferritins / Q000276:immunology; D018380:Hematopoietic Stem Cell Transplantation; D006689:Hodgkin Disease / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods; D017730:Ki-1 Antigen / Q000276:immunology; D015182:Lymphatic Irradiation; D008297:Male; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant; D000069283:Rituximab; D016879:Salvage Therapy; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D018796:Immunoconjugates; D017730:Ki-1 Antigen; D000069283:Rituximab; D005293:Ferritins; C510955:iratumumab