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[Initial treatment strategy for classical Hodgkin lymphoma in adults].

Authors:
Shigeru Kusumoto

Rinsho Ketsueki 2021 ;62(8):1102-1111

Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences.

Four cycles of ABVD followed by 30 Gy IFRT (ISRT) is a standard regimen, as an initial treatment, for patients with early-stage classical Hodgkin lymphoma (cHL), whereas 2 cycles of ABVD followed by 20 Gy IFRT (ISRT) is an alternative regimen for those with favorable early-stage cHL. For patients with unfavorable early-stage cHL including bulky disease, local radiotherapy can be safely omitted if negative findings on interim PET are obtained after 2 cycles of escalated BEACOPP plus 2 cycles of ABVD. ABVD (6/8 cycles) or brentuximab vedotin (BV) with concurrent AVD (6 cycles) is a standard regimen for patients with advanced-stage cHL. Read More

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September 2021

Review of Treatment Options for the Management of Advanced Stage Hodgkin Lymphoma.

Cancers (Basel) 2021 Jul 26;13(15). Epub 2021 Jul 26.

Department of Hematology, CHU UCL, 530 Yvoir, Belgium.

Hodgkin lymphoma (HL) is a lymphoid-type hematologic disease that is derived from B cells. The incidence of this lymphoid malignancy is around 2-3/100,000/year in the western world. Long-term remission rates are linked to a risk-adapted approach, which allows remission rates higher than 80%. Read More

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Intensified treatment of patients with early stage, unfavourable Hodgkin lymphoma: long-term follow-up of a randomised, international phase 3 trial of the German Hodgkin Study Group (GHSG HD14).

Lancet Haematol 2021 Apr;8(4):e278-e288

German Hodgkin Study Group, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Germany; Department of Hematology and Stem Cell Transplantation and Cancer Center Cologne Essen-Partner Site Essen, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. Electronic address:

Background: To improve the long-term tumour control in early, unfavourable Hodgkin Lymphoma, the German Hodgkin Study Group (GHSG) HD14 trial compared four cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with an intensified chemotherapy regimen consisting of two cycles of escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (escalated BEACOPP) plus two cycles of ABVD. The final analysis of the trial showed a significant advantage in terms of freedom from treatment failure (difference 7·2% [95% CI 3·8-10·5] at 5 years) for patients who received two cycles of escalated BEACOPP and two cycles of ABVD. However, there was no difference in overall survival between the two groups. Read More

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Advanced Hodgkin lymphoma in the East of England: a 10-year comparative analysis of outcomes for real-world patients treated with ABVD or escalated-BEACOPP, aged less than 60 years, compared with 5-year extended follow-up from the RATHL trial.

Ann Hematol 2021 Apr 27;100(4):1049-1058. Epub 2021 Feb 27.

Department of Haematology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK.

Treatment with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) or escalated(e)-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisolone) remains the international standard of care for advanced-stage classical Hodgkin lymphoma (HL). We performed a retrospective, multicentre analysis of 221 non-trial ("real-world") patients, aged 16-59 years, diagnosed with advanced-stage HL in the Anglia Cancer Network between 2004 and 2014, treated with ABVD or eBEACOPP, and compared outcomes with 1088 patients in the Response-Adjusted Therapy for Advanced Hodgkin Lymphoma (RATHL) trial, aged 18-59 years, with median follow-up of 87.0 and 69. Read More

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Characteristics and outcome of patients with relapsed/refractory Hodgkin lymphoma following front-line escalated BEACOPP-based chemotherapy: a report from the Australasian Lymphoma Alliance.

Leuk Lymphoma 2020 12 28;61(14):3412-3416. Epub 2020 Aug 28.

Gold Coast University Hospital, Southport, Australia.

The optimal management of the small number of patients who experience early failure of eBEACOPP in Hodgkin lymphoma (HL) is unclear. We identified 12 patients with HL who progressed within 12 months of the front-line therapy between January 2010 and July 2019. Median time of first progression following diagnosis was 7 months (range 2. Read More

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December 2020

Hodgkin's lymphoma: post- autologous transplantation consolidation therapy.

Acta Biomed 2020 05 25;91(S-5):23-29. Epub 2020 May 25.

Onco-Hematology Division, IEO, European Institute of Oncology, IRCCS, Milan, Italy.

A first-line chemotherapy program based on the ABVD regimen is currently considered the golden standard by most hematologists, being able to achieve a cure without any need of subsequent therapies in >70% of patients with advanced-stage Hodgkin's lymphoma (HL). To increase this percentage, efforts in recent decades focused on the development of new therapeutic strategies. A first major effort was the introduction of the BEACOPP chemotherapy regimen, which is able to increase the response rate and to reduce the need of salvage therapies. Read More

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Self-Reported Sexual Function in Sexually Active Male Hodgkin Lymphoma Survivors.

Sex Med 2020 Sep 2;8(3):428-435. Epub 2020 Jun 2.

Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Introduction: Unambiguous data on sexual dysfunction after Hodgkin lymphoma (HL) treatment are scarce.

Aims: To form a baseline in this area, we compared patient-reported sexual function in sexually active male HL survivors in complete remission with a sexually active, age-matched, male Dutch sample population. Furthermore, we explored whether sociodemographic and clinical factors were associated with sexual dysfunction in HL survivors and investigated whether reporting to perceive sexual problems was indicative for sexual dysfunction. Read More

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September 2020

Whole-slide image analysis of the tumor microenvironment identifies low B-cell content as a predictor of adverse outcome in patients with advanced-stage classical Hodgkin lymphoma treated with BEACOPP.

Haematologica 2021 06 1;106(6):1684-1692. Epub 2021 Jun 1.

University Hospital Schleswig-Holstein, Christian-Albrechts-University, Kiel, Germany.

A subset of patients with advanced-stage classical Hodgkin Lymphoma (cHL) relapse or progress following standard treatment. Given their dismal prognosis, identifying this group of patients upfront represents an important medical need. While prior research has identified characteristics of the tumor microenvironment, which are associated with cHL outcomes, biomarkers that are developed and validated in this high-risk group are still missing. Read More

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Cost-effectiveness of first-line treatment options for patients with advanced-stage Hodgkin lymphoma: a modelling study.

Lancet Haematol 2020 Feb 13;7(2):e146-e156. Epub 2020 Jan 13.

Department of Medicine, University of Toronto, Toronto, ON, Canada; Princess Margaret Cancer Centre, Toronto, ON, Canada. Electronic address:

Background: Several strategies are available for the initial treatment of advanced-stage Hodgkin lymphoma, but the optimal strategy in terms of cost-effectiveness is unclear. The aim of this study was to compare the quality-adjusted effectiveness and costs of five modern treatment options for transplantation-eligible patients with newly diagnosed advanced-stage Hodgkin lymphoma.

Methods: A Markov decision-analytic model was developed using a 20-year time horizon. Read More

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February 2020

Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies.

Cochrane Database Syst Rev 2020 01 13;1:CD012643. Epub 2020 Jan 13.

Faculty of Medicine and University Hospital Cologne, University of Cologne, Cochrane Cancer, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Kerpener Str. 62, Cologne, Germany, 50937.

Background: Hodgkin lymphoma (HL) is one of the most common haematological malignancies in young adults and, with cure rates of 90%, has become curable for the majority of individuals. Positron emission tomography (PET) is an imaging tool used to monitor a tumour's metabolic activity, stage and progression. Interim PET during chemotherapy has been posited as a prognostic factor in individuals with HL to distinguish between those with a poor prognosis and those with a better prognosis. Read More

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January 2020

Interim PET-results for prognosis in adults with Hodgkin lymphoma: a systematic review and meta-analysis of prognostic factor studies.

Cochrane Database Syst Rev 2019 09 16;9:CD012643. Epub 2019 Sep 16.

University of Cologne, Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematological Malignancies, Kerpener Str. 62, Cologne, Germany, 50937.

Background: Hodgkin lymphoma (HL) is one of the most common haematological malignancies in young adults and, with cure rates of 90%, has become curable for the majority of individuals. Positron emission tomography (PET) is an imaging tool used to monitor a tumour's metabolic activity, stage and progression. Interim PET during chemotherapy has been posited as a prognostic factor in individuals with HL to distinguish between those with a poor prognosis and those with a better prognosis. Read More

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September 2019

Dual-point FDG-PET/CT for treatment response assessment in Hodgkin lymphoma, when an FDG-avid lesion persists after treatment.

Am J Nucl Med Mol Imaging 2019 15;9(3):176-184. Epub 2019 Jun 15.

Research and Clinical, Innovation Department, A. Lacassagne Cancer Centre Nice, France.

FDG-PET/CT (PET) is now considered the standard imaging tool for Hodgkin Lymphoma (HL) staging and restaging. However a CT-detected residual mass at the end of therapy (EoT) is still a challenge for PET interpretation. The aim of our study was to improve the overall accuracy of EoT PET/CT by using a dynamic dual-point scanning at 60 and 120 after FDG injection (2P-PET/CT). Read More

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Neutropenia during frontline treatment of advanced Hodgkin lymphoma: Incidence, risk factors, and management.

Crit Rev Oncol Hematol 2019 Jun 29;138:1-5. Epub 2019 Mar 29.

Millennium Pharmaceuticals, Inc. (a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), 350 Massachusetts Avenue, Cambridge, MA, 02139, United States. Electronic address:

Neutropenia, specifically febrile neutropenia (FN), can have profound sequelae (infection, hospitalization, mortality), and the risk of its development differs across chemotherapy regimens/according to patient characteristics. We conducted a comprehensive literature review regarding neutropenia in frontline treatment of adults with advanced Hodgkin lymphoma. Guidelines state primary prophylaxis (PP) with colony-stimulating factors (CSFs) should be implemented when the risk of FN is ≥20%; CSF PP is given with standard-of-care escalated BEACOPP, but the risk of FN with standard-of-care ABVD does not necessitate routine PP. Read More

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Comparative effectiveness of different chemotherapy regimens of advanced-stage Hodgkin lymphoma in adults: a network meta-analysis.

Cancer Manag Res 2018 22;10:6017-6028. Epub 2018 Nov 22.

Department of Oncology, Weifang Traditional Chinese Hospital, Weifang, Shandong Province, People's Republic of China,

Background: Combined chemotherapy is the cornerstone treatment for patients with advanced Hodgkin lymphoma (HL). The objective of our study was to perform a network meta-analysis of the efficacy of different chemotherapy regimens in adults with advanced-stage HL.

Materials And Methods: We searched for relevant randomized controlled trials (RCTs) in titles/abstracts in PubMed, Embase, and the Cochrane Library. Read More

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November 2018

[Successful treatment with brentuximab vedotin maintenance therapy after autologous stem cell transplantation in high-risk Hodgkin lymphoma].

Rinsho Ketsueki 2018;59(8):1002-1006

Department of Internal Medicine, Kansai Medical University.

A 56-year-old woman was diagnosed with classical Hodgkin lymphoma in December 2012. She achieved complete remission (CR) with six cycles of adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD). In March 2015, she experienced a relapse marked by high fever, respiratory discomfort, and pain in the left thigh owing to tumor involvement of the femur. Read More

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Outcome-based interpretation of early interim PET in advanced-stage Hodgkin lymphoma.

Blood 2018 11 30;132(21):2273-2279. Epub 2018 Aug 30.

Department of Nuclear Medicine.

The HD18 study for patients with newly diagnosed advanced-stage Hodgkin lymphoma (HL) used positron emission tomography (PET) after 2 cycles (PET-2) of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone in escalated doses (eBEACOPP) to guide further treatment. Here, we analyzed the impact of PET-2 results in the context of eBEACOPP according to the Deauville score (DS) in patients treated within the HD18 trial. Residual tissue was visually compared with reference regions according to DS. Read More

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November 2018

Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 Trial.

J Clin Oncol 2018 02 23;36(5):454-462. Epub 2018 Jan 23.

Andrea Gallamini, Centre Antoine Lacassagne, Nice, France; Corrado Tarella, Istituto Europeo di Oncologia; Daniela Gottardi, Ospedale Mauriziano Umberto I di Torino; Paolo Gavarotti, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Turin; Simonetta Viviani and Paolo Corradini, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori; Paolo Corradini, Alessandro Massimo Gianni, and Alessandro Rambaldi, Università degli Studi di Milano; Andrés J.M. Ferreri and Federico Fallanca, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale San Raffaele; Giuseppe Prosperini, Istituto di Ricovero e Cura a Carattere Scientifico-Istituto di Ricerche Farmacologiche Mario Negri, Milan; Andrea Rossi, Chiara Pavoni, and Alessandro Rambaldi, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo; Caterina Patti and Antonino Mulé, Azienda Villa Sofia-Cervello; Umberto Ficola, La Maddalena, Palermo; Marco Picardi, Università Federico II, Naples; Alessandra Romano, Ospedale Ferrarotto, Catania; Maria Cantonetti, Policlinico Tor Vergata; Roberta Battistini, Ospedale San Camillo; Agostino Chiaravalloti, Università Tor Vergata, Rome; Giorgio La Nasa, Ospedale Roberto Binaghi di Cagliari, Cagliari; Livio Trentin, Università di Padova, Padua; Silvia Bolis, Ospedale San Gerardo, Monza; Davide Rapezzi, Alberto Biggi, Fabrizio Bergesio, and Stephane Chauvie, Azienda Ospedaliera Santa Croce e Carle, Cuneo; Michele Cimminiello, Ospedale San Carlo, Potenza; Corrado Schiavotto, Presidio Ospedaliero San Bortolo, Vicenza; Guido Parvis, Azienda Ospedaliera San Luigi, Orbassano; Roberta Zanotti, Azienda Ospedaliera Universitaria Integrata, Verona; Guido Gini, Nuovo Ospedale Torrette, Ancona; Piera Viero, Ospedale dell'Angelo, Mestre; Maurizio Miglino, Azienda Ospedaliera Universitaria San Martino, Genoa; Atto Billio, Ospedale Centrale di Bolzano, Bolzano; Michele Gregianin, Ospedale San Giacomo, Castelfranco Veneto, Italy; and Abraham Avigdor, Chaim Sheba Medical Center, Tel HaShomer, Israel.

Purpose To investigate the progression-free survival (PFS) of patients with advanced Hodgkin lymphoma (HL) after a risk-adapted treatment strategy that was based on a positive positron emission tomography scan performed after two doxorubicin, vinblastine, vincristine, and dacarbazine (ABVD) cycles (PET2). Patients and Methods Patients with advanced-stage (IIB to IVB) HL were consecutively enrolled. After two ABVD cycles, PET2 was performed and centrally reviewed according to the Deauville five-point scale. Read More

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February 2018

PET-adapted therapy for advanced Hodgkin lymphoma - systematic review.

Acta Oncol 2018 Jun 18;57(6):765-772. Epub 2018 Jan 18.

a Institute of Hematology , Davidoff Cancer Center , Petah-Tikva , Israel.

Introduction: Positron emission tomography-computed tomography (PET-CT) performed after two chemotherapy cycles (PET-2) has become an accepted prognostic tool in Hodgkin lymphoma (HL). We evaluated the effect of PET-adapted strategy on outcome in advanced stage HL.

Methods: In August 2017, we searched electronic databases, conference proceedings and ongoing trials. Read More

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Reduced-Intensity Chemotherapy in Patients With Advanced-Stage Hodgkin Lymphoma: Updated Results of the Open-Label, International, Randomised Phase 3 HD15 Trial by the German Hodgkin Study Group.

Hemasphere 2017 Dec 20;1(1):e5. Epub 2017 Dec 20.

German Hodgkin Study Group (GHSG), Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany.

The international, randomized phase 3 HD15 trial established 6xeBEACOPP as standard therapy for patients with newly diagnosed advanced-stage Hodgkin lymphoma (HL) within the German Hodgkin Study Group (GHSG). We performed a follow-up analysis to assess long-term efficacy and safety of this approach. Between 2003 and 2008, 2182 patients aged 18 to 60 years were recruited and randomized in a 1:1:1 ratio between 8 or 6 cycles of eBEACOPP or 8 cycles of the dose-dense BEACOPP-14 regimen, each followed by 30 Gy radiotherapy in case of positron emission tomography (PET)-positive residual lesions ≥2. Read More

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December 2017

Incorporation of brentuximab vedotin into first-line treatment of advanced classical Hodgkin's lymphoma: final analysis of a phase 2 randomised trial by the German Hodgkin Study Group.

Lancet Oncol 2017 12 10;18(12):1680-1687. Epub 2017 Nov 10.

First Department of Internal Medicine, University Hospital of Cologne, Cologne, Germany; German Hodgkin Study Group (GHSG), University Hospital of Cologne, Cologne, Germany. Electronic address:

Background: A high proportion of patients with relapsed classical Hodgkin's lymphoma achieve a response with the antibody-drug conjugate brentuximab vedotin, and the drug is well tolerated. We modified the escalated BEACOPP regimen (eBEACOPP; bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) and implemented brentuximab vedotin with the aim to reduce toxic effects while maintaining the protocol's efficacy.

Methods: We did an open-label, multicentre, randomised phase 2 study at 20 study sites in Germany. Read More

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December 2017

PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group.

Lancet 2017 12 20;390(10114):2790-2802. Epub 2017 Oct 20.

Department of Radiotherapy, University Hospital of Cologne, Cologne, Germany.

Background: The intensive polychemotherapy regimen eBEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone in escalated doses) is very active in patients with advanced-stage Hodgkin's lymphoma, albeit at the expense of severe toxicities. Individual patients might be cured with less burdensome therapy. We investigated whether metabolic response determined by PET after two cycles of standard regimen eBEACOPP (PET-2) would allow adaption of treatment intensity, increasing it for PET-2-positive patients and reducing it for PET-2-negative patients. Read More

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December 2017

Optimisation of chemotherapy and radiotherapy for untreated Hodgkin lymphoma patients with respect to second malignant neoplasms, overall and progression-free survival: individual participant data analysis.

Cochrane Database Syst Rev 2017 09 13;9:CD008814. Epub 2017 Sep 13.

Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Kerpener Str. 62, Cologne, Germany, 50937.

Background: Efficacy and the risk of severe late effects have to be well-balanced in treatment of Hodgkin lymphoma (HL). Late adverse effects include secondary malignancies which often have a poor prognosis. To synthesise evidence on the risk of secondary malignancies after current treatment approaches comprising chemotherapy and/or radiotherapy, we performed a meta-analysis based on individual patient data (IPD) from patients treated for newly diagnosed HL. Read More

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September 2017

Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial.

J Clin Oncol 2017 Jun 14;35(16):1786-1794. Epub 2017 Mar 14.

Marc P.E. André, Université Catholique de Louvain, Yvoir; Catherine Fortpied, Valeria Fiaccadori, and Tiana Raveloarivahy, European Organisation for Research and Treatment of Cancer, Brussels, Belgium; Théodore Girinsky and Christophe Fermé, Institut Gustave Roussy, Villejuif; Oumédaly Reman, Institut d'Hématologie de Basse Normandie, Centre Hospitalier Universitaire, Caen; Pauline Brice, Assistance Publique des Hopitaux de Paris Hôpital Saint-Louis; Richard Delarue, Assistance Publique des Hopitaux de Paris Hôpital Universitaire Necker-Enfants Maladies, Paris; Olivier Casasnovas, Centre Hospitalier Universitaire le Bocage and Institut National de la Santé et de la Recherche Médicale, Dijon; Véronique Edeline, Hôpital René Hugenin-Institut Curie, Saint Cloud; Réda Bouabdallah, Institut Paoli Calmette, Marseille; Catherine Sebban, Hematology Centre Léon Bérard, Lyon; Aspasia Stamatoullas, Centre Henri Becquerel, Rouen; Michel Meignan, Henri Mondor University Hospitals, Créteil, France; Massimo Federico and Monica Bellei, University of Modena and Reggio Emilia, Modena; Manuel Gotti, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia; Alessandro Re, Spedali Civili Hospital, Brescia; Francesco Merli and Annibale Versari, Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico, Reggio Emilia, Italy; Richard van der Maazen and John Raemaekers, Radboud University Medical Center, Nijmegen; Gustaaf van Imhoff, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands; and Lena Specht and Martin Hutchings, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

Purpose Patients who receive combined modality treatment for stage I and II Hodgkin lymphoma (HL) have an excellent outcome. Early response evaluation with positron emission tomography (PET) scan may improve selection of patients who need reduced or more intensive treatments. Methods We performed a randomized trial to evaluate treatment adaptation on the basis of early PET (ePET) after two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in previously untreated-according to European Organisation for Research and Treatment of Cancer criteria favorable (F) and unfavorable (U)-stage I and II HL. Read More

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Progression-free survival of early interim PET-positive patients with advanced stage Hodgkin's lymphoma treated with BEACOPP alone or in combination with rituximab (HD18): an open-label, international, randomised phase 3 study by the German Hodgkin Study Group.

Lancet Oncol 2017 04 22;18(4):454-463. Epub 2017 Feb 22.

Department of Internal Medicine I, University Hospital of Cologne, Cologne, Germany; German Hodgkin Study Group, Cologne, Germany.

Background: Advanced stage Hodgkin's lymphoma represents a heterogeneous group of patients with different risk profiles. Data suggests that interim PET assessment during chemotherapy is superior to baseline international prognostic scoring in terms of predicting long-term treatment outcome in patients with Hodgkin's lymphoma. We therefore hypothesised that early interim PET-imaging after two courses of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) might be suitable for guiding treatment in patients with advanced stage Hodgkin's lymphoma. Read More

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Response-adapted frontline therapy for Hodgkin lymphoma: are we there yet?

Hematology Am Soc Hematol Educ Program 2016 Dec;2016(1):316-322

Cancer Research UK Centre, University of Southampton, Southampton, United Kingdom.

Treating Hodgkin lymphoma by using chemotherapy with or without radiotherapy is highly successful, with substantially fewer deaths from lymphoma than from other causes in recent studies of both early-stage and advanced-stage disease. Long-term toxicity is a major consideration in this context, and recent trials have used functional imaging with [F]fluorodeoxyglucose (FDG) positron emission tomography early in the course of treatment (interim PET) to assess response and modulate subsequent therapy. In early-stage disease, this has allowed omission of consolidation radiotherapy after a good response to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) chemotherapy, and trials have shown that this can be done without detriment to overall survival, despite a small increase in rates of recurrence of ∼5%. Read More

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December 2016

Mediastinal gray zone lymphoma: clinico-pathological characteristics and outcomes of 99 patients from the Lymphoma Study Association.

Haematologica 2017 01 6;102(1):150-159. Epub 2016 Oct 6.

INSERM1052, CNRS 5286, Université Claude Bernard, Faculté de Médecine Lyon-Sud Charles Mérieux Lyon-1, Pierre Bénite cedex, France.

Mediastinal gray zone lymphoma, B-cell lymphomas with intermediate features between classical Hodgkin lymphoma and primary mediastinal B-cell lymphoma, have not been well described in the literature. We report the clinical characteristics and outcomes of a large retrospective series of 99 cases centrally reviewed by a panel of hematopathologists, with a consensus established for the diagnosis. Cases were defined as classical Hodgkin lymphoma-like morphology (64. Read More

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January 2017

Comparison of the efficiency of ABVD versus BEACOPP for Hodgkin lymphoma treatment: a meta-analysis.

Int J Hematol 2016 Oct 16;104(4):413-9. Epub 2016 Aug 16.

Hematology Department, The 1st Affiliated Hospital of Nanchang University, No. 17 Yongwaizheng Street, Donghu District, Nanchang, 33000, Jiangxi, China.

To compare the efficiency of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) against that of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) for treating Hodgkin lymphoma (HL). An extensive English-language literature retrieval on clinical outcomes after treatment by ABVD versus BEACOPP was conducted on Medline, PubMed, and Embase through the period ending December 2015. Odds ratio (OR) with corresponding 95 % confidence interval (95 % CI) was pooled based on the heterogeneity across individual studies. Read More

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October 2016

No survival benefit associated with routine surveillance imaging for Hodgkin lymphoma in first remission: a Danish-Swedish population-based observational study.

Br J Haematol 2016 Apr 5;173(2):236-44. Epub 2016 Feb 5.

Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.

The use of routine imaging for patients with classical Hodgkin lymphoma (HL) in complete remission (CR) is controversial. In a population-based study, we examined the post-remission survival of Danish and Swedish HL patients for whom follow-up practices were different. Follow-up in Denmark included routine imaging, usually for a minimum of 2 years, whereas clinical follow-up without routine imaging was standard in Sweden. Read More

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[Nodular lymphocyte-predominant Hodgkin's lymphoma: Principles of diagnosis and treatment].

Ter Arkh 2015 ;87(11):78-83

Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.

Aim: To describe the clinical and morphological features of the rare Hodgkin's lymphoma (HL) subtype--nodular lymphocyte-predominant HL (NLPHL).

Subjects And Methods: Forty-two patients were diagnosed with NLPHL in 2010 to 2014. The male to female ratio was 2. Read More

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Long-Term Results of the HD2000 Trial Comparing ABVD Versus BEACOPP Versus COPP-EBV-CAD in Untreated Patients With Advanced Hodgkin Lymphoma: A Study by Fondazione Italiana Linfomi.

J Clin Oncol 2016 Apr 28;34(11):1175-81. Epub 2015 Dec 28.

Francesco Merli, Caterina Mammi, Fiorella Ilariucci, and Angela Ferrari, Azienda Ospedaliera Arcispedale S. Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS); Reggio Emilia; Stefano Luminari, Luigi Marcheselli, and Massimo Federico, University of Modena and Reggio Emilia, Modena; Paolo G. Gobbi, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia; Nicola Cascavilla and Potito Rosario Scalzulli, IRCCS "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo; Caterina Stelitano, A.O. Bianchi Melacrino Morelli, Reggio Calabria; Maurizio Musso, Ospedale La Maddalena, Palermo; Luca Baldini, Fondazione IRCCS Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milano; Sara Galimberti, University of Pisa, Pisa; Francesco Angrilli, Ospedale Santo Spirito, Pescara; and Giuseppe Polimeno, Ospedale "Miulli," Acquaviva delle Fonti, Bari, Italy.

Purpose: The randomized HD2000 trial compared six cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), four escalated plus two standard cycles of BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), and six cycles of COPP-EBV-CAD (cyclophosphamide, lomustine, vindesine, melphalan, prednisone, epidoxorubicin, vincristine, procarbazine, vinblastine, and bleomycin; CEC) in patients with advanced-stage Hodgkin lymphoma. After a median follow-up of 42 months, patients who received BEACOPP were reported to have experienced better progression-free survival (PFS) but not better overall survival (OS) results than those receiving ABVD. We here report a post hoc analysis of this trial after a median follow-up of 10 years. Read More

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