title: Classical Hodgkin's lymphoma: the Lymphoma Study Association guidelines for relapsed and refractory adult patients eligible for transplant.
abstract: The Hodgkin's Lymphoma Committee of the Lymphoma Study Association (LYSA) gathered in 2012 to prepare guidelines on the management of transplant-eligible patients with relapsing or refractory Hodgkin's lymphoma. The working group is made up of a multidisciplinary panel of experts with a significant background in Hodgkin's lymphoma. Each member of the panel of experts provided an interpretation of the evidence and a systematic approach to obtain consensus was used. Grades of recommendation were not required since levels of evidence are mainly based on phase II trials or standard practice. Data arising from randomized trials are emphasized. The final version was endorsed by the scientific council of the LYSA. The expert panel recommends a risk-adapted strategy (conventional treatment, or single/double transplantation and/or radiotherapy) based on three risk factors at progression (primary refractory disease, remission duration < 1 year, stage III/IV), and an early evaluation of salvage chemosensitivity, including (18)fluorodeoxy glucose-positron emission tomography interpreted according to the Deauville scoring system. Most relapsed or refractory Hodgkin's lymphoma patients chemosensitive to salvage should receive high-dose therapy and autologous stem-cell transplantation as standard. Efforts should be made to increase the proportion of chemosensitive patients by alternating non-cross-resistant chemotherapy lines or exploring the role of novel drugs.
authors.affiliation: Cliniques Universitaires UCL Saint-Luc, Brussels, Belgium. eric.vandenneste@uclouvain.be
authors.forename: Eric
authors.initials: E
authors.lastname: Van Den Neste
authors.forename: Olivier
authors.initials: O
authors.lastname: Casasnovas
authors.forename: Marc
authors.initials: M
authors.lastname: André
authors.forename: Mohamed
authors.initials: M
authors.lastname: Touati
authors.forename: Delphine
authors.initials: D
authors.lastname: Senecal
authors.forename: Véronique
authors.initials: V
authors.lastname: Edeline
authors.forename: Aspasia
authors.initials: A
authors.lastname: Stamatoullas
authors.forename: Luc
authors.initials: L
authors.lastname: Fornecker
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Deau
authors.forename: Thomas
authors.initials: T
authors.lastname: Gastinne
authors.forename: Oumédaly
authors.initials: O
authors.lastname: Reman
authors.forename: Isabelle
authors.initials: I
authors.lastname: Gaillard
authors.forename: Cécile
authors.initials: C
authors.lastname: Borel
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.forename: Christophe
authors.initials: C
authors.lastname: Fermé
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods / Q000592:standards*; D006689:Hodgkin Disease / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic / Q000592:standards*; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards; D016879:Salvage Therapy / Q000379:methods / Q000592:standards; D012955:Societies, Medical / Q000592:standards
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