title: Advances in the treatment of relapsed or refractory Hodgkin's lymphoma.
abstract: Hodgkin's lymphoma (HL) is diagnosed in 20,000 men and women annually in North America and Europe. Despite treatment advancements for HL resulting in an overall survival rate of 80%, patients with advanced stage disease continue to have suboptimal outcomes, with relapse rates of 30%-40%. An additional 10%-15% of patients present with primary refractory disease. For patients who relapse after initial treatment, salvage chemotherapy followed by autologous stem cell transplant in those with chemotherapy-sensitive disease is the standard of care. Patients who relapse after second-line therapy have a median survival time in the range of 6-36 months, and the optimal management of these patients remains unclear. Unfortunately, there have been no new agents approved for relapsed HL treatment since the 1970s. Consequently, clinical decision making in this population is difficult. Recently however, several agents have emerged that have shown clinical promise in this poor-risk population. This review discusses the management of these patients and also discusses several newer agents showing clinical promise in the treatment of HL.
authors.affiliation: Department of Hematology Oncology, 4245 Karmanos Cancer Institute, Detroit, Michigan 48201, USA. ramchanr@karmanos.org
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Ramchandren
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D001897:Boronic Acids / Q000627:therapeutic use; D000069286:Bortezomib; D000079963:Brentuximab Vedotin; D004358:Drug Therapy / Q000379:methods*; D000068338:Everolimus; D056572:Histone Deacetylase Inhibitors / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000473:pathology / Q000628:therapy*; D006801:Humans; D018796:Immunoconjugates / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D000077269:Lenalidomide; D011480:Protease Inhibitors / Q000627:therapeutic use; D011719:Pyrazines / Q000627:therapeutic use; D012008:Recurrence; D000069283:Rituximab; D055502:Secondary Prevention; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D001897:Boronic Acids; D056572:Histone Deacetylase Inhibitors; D018796:Immunoconjugates; D011480:Protease Inhibitors; D011719:Pyrazines; D000069283:Rituximab; D013792:Thalidomide; D000069286:Bortezomib; D000079963:Brentuximab Vedotin; D000068338:Everolimus; D000077269:Lenalidomide; D020123:Sirolimus