Current strategies and new approaches in the treatment of Hodgkin's lymphoma.
As a result of continuous improvement in therapeutic options and their verification by large multicenter trials, Hodgkin's lymphoma (HL) has become one of the best curable cancers in adults. Nowadays, about 80-90% of patients in all stages achieve long-term survival. Nevertheless, these good results are threatened by treatment-associated toxicities such as infertility, cardiopulmonary toxicity and secondary malignancies. It is therefore the aim of future trial generations both to maintain excellent treatment results and to minimize late effects. At early stages, ongoing trials ask how many cycles of ABVD-like chemotherapy are necessary and if radiation doses might be further reduced or even omitted in favorable early-stage disease. In advanced stages, new combinations of chemotherapeutic drugs with higher dose densities are tested with or without the application of consolidating radiotherapy. The treatment of patients with relapsed HL depends on previous therapies with radiotherapy, chemotherapy or high-dose chemotherapy followed by autologous stem cell transplantation. For patients with multiple relapses, experimental treatment strategies include antibody- and small-molecule-based regimens. In this review we present current treatment strategies for patients with a first diagnosis of HL and relapsed HL as well as recent experimental therapeutic approaches.
Fuchs
Michael
M
Hematology and Medical Oncology, University Hospital of Cologne, Cologne, Germany.
Diehl
Volker
V
Re
Daniel
D
D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000145:classification / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant