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International Journal of Hematology
Published in: International Journal of Hematology 5/2012

01-11-2012 | Progress in Hematology

Advances in the treatment of Hodgkin lymphoma

Authors: Dennis A. Eichenauer, Andreas Engert

Published in: International Journal of Hematology | Issue 5/2012

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Abstract

In the past decades, Hodgkin lymphoma (HL) has turned from an incurable disease to one with the most favorable prognosis among adult malignancies. This is due to the introduction of effective multi-agent chemotherapy and the optimization of radiation techniques. At present, 80–90 % of patients achieve long-term remission when receiving appropriate first-line treatment. Even in case of relapse, up to 50 % can be successfully salvaged with high-dose chemotherapy and autologous stem cell transplantation. Thus, current studies do not necessarily aim at increasing treatment efficacy but rather focus on a possible reduction of acute and late toxicity by decreasing treatment intensity if possible. One promising strategy to spare therapy in good-risk patients is early response-adapted treatment stratification according to the result of interim positron emission tomography. The evaluation of novel drugs and the optimization of treatment for elderly HL patients and those with nodular lymphocyte-predominant HL are further aspects that are currently being addressed in ongoing trials. This review will give an overview on more recent clinical trials and discuss possible future strategies for the treatment of HL.
Literature
1.
Eichenauer DA, Engert A, Dreyling M. Hodgkin’s lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2011;22 Suppl 6:vi55–8.
2.
Engert A, Franklin J, Eich HT, Brillant C, Sehlen S, Cartoni C, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007 Aug 10;25(23):3495-502.PubMedCrossRef
3.
Ferme C, Eghbali H, Meerwaldt JH, Rieux C, Bosq J, Berger F, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin’s disease. N Engl J Med. 2007;357(19):1916–27.PubMedCrossRef
4.
Engert A, Plutschow A, Eich HT, Lohri A, Dorken B, Borchmann P, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363(7):640–52.PubMedCrossRef
5.
Borchmann P, Diehl V, Goergen H, Lohri A, Zijlstra J, Topp M, et al. Dacarbazine is an essential component of ABVD in the treatment of early favourable Hodgkin lymphoma: results of the second interim analysis of the GHSG HD13 trial. Haematologica. 2010;95, Suppl. 2(473):A1146.
6.
Eich HT, Diehl V, Gorgen H, Pabst T, Markova J, Debus J, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010;28(27):4199–206.PubMedCrossRef
7.
Noordijk EM, Thomas J, Ferme C, van’t Veer MB, Brice P, Divine M, et al. First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin’s lymphoma (HL). ASCO Meeting Abstracts. 2005;23(16 Suppl):6505.
8.
von Tresckow B, Plutschow A, Fuchs M, Klimm B, Markova J, Lohri A, et al. Dose-intensification in early unfavorable Hodgkin’s lymphoma: final analysis of the German hodgkin study group HD14 trial. J Clin Oncol. 2012;30(9):907–13.CrossRef
9.
Diehl V, Franklin J, Hasenclever D, Tesch H, Pfreundschuh M, Lathan B, et al. BEACOPP, a new dose-escalated and accelerated regimen, is at least as effective as COPP/ABVD in patients with advanced-stage Hodgkin’s lymphoma: interim report from a trial of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol. 1998;16(12):3810–21.PubMed
10.
Meyer RM, Gospodarowicz MK, Connors JM, Pearcey RG, Wells WA, Winter JN, et al. ABVD alone versus radiation-based therapy in limited-stage Hodgkin’s lymphoma. N Engl J Med. 2012;366(5):399–408.PubMedCrossRef
11.
Canellos GP, Anderson JR, Propert KJ, Nissen N, Cooper MR, Henderson ES, et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992;327(21):1478–84.PubMedCrossRef
12.
Canellos GP, Niedzwiecki D. Long-term follow-up of Hodgkin’s disease trial. N Engl J Med. 2002;346(18):1417–8.PubMedCrossRef
13.
Canellos GP, Niedzwiecki D, Johnson JL. Long-term follow-up of survival in Hodgkin’s lymphoma. N Engl J Med. 2009;361(24):2390–1.PubMedCrossRef
14.
Diehl V, Franklin J, Pfreundschuh M, Lathan B, Paulus U, Hasenclever D, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. N Engl J Med. 2003;348(24):2386–95.PubMedCrossRef
15.
Engert A, Diehl V, Franklin J, Lohri A, Dorken B, Ludwig WD, et al. Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin’s lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol. 2009;27(27):4548–54.PubMedCrossRef
16.
Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A, et al. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin’s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet. 2012;379(9828):1791–9.PubMedCrossRef
17.
Weihrauch MR, Manzke O, Beyer M, Haverkamp H, Diehl V, Bohlen H, et al. Elevated serum levels of CC thymus and activation-related chemokine (TARC) in primary Hodgkin’s disease: potential for a prognostic factor. Cancer Res. 2005;65(13):5516–9.PubMedCrossRef
18.
Plattel WJ, van den Berg A, Visser L, van der Graaf AM, Pruim J, Vos H, et al. Plasma thymus and activation-regulated chemokine as an early response marker in classical Hodgkin’s lymphoma. Haematologica. 2012;97(3):410–5.PubMedCrossRef
19.
Steidl C, Lee T, Shah SP, Farinha P, Han G, Nayar T, et al. Tumor-associated macrophages and survival in classic Hodgkin’s lymphoma. N Engl J Med. 2010;362(10):875–85.PubMedCrossRef
20.
Tan KL, Scott DW, Hong F, Kahl BS, Fisher RI, Bartlett NL, et al. Tumor-associated macrophages predict inferior outcomes in classical Hodgkin lymphoma: a correlative study from the E2496 Intergroup trial. Blood. 2012 Sep 4.
21.
Linch DC, Winfield D, Goldstone AH, Moir D, Hancock B, McMillan A, et al. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin’s disease: results of a BNLI randomised trial. Lancet. 1993;341(8852):1051–4.PubMedCrossRef
22.
Schmitz N, Pfistner B, Sextro M, Sieber M, Carella AM, Haenel M, et al. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin’s disease: a randomised trial. Lancet. 2002;359(9323):2065–71.PubMedCrossRef
23.
Josting A, Muller H, Borchmann P, Baars JW, Metzner B, Dohner H, et al. Dose intensity of chemotherapy in patients with relapsed Hodgkin’s lymphoma. J Clin Oncol. 2010;28(34):5074–80.PubMedCrossRef
24.
Santoro A, Magagnoli M, Spina M, Pinotti G, Siracusano L, Michieli M, et al. Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin’s lymphoma. Haematologica. 2007;92(1):35–41.PubMedCrossRef
25.
Moskowitz CH, Nimer SD, Zelenetz AD, Trippett T, Hedrick EE, Filippa DA, et al. A 2-step comprehensive high-dose chemoradiotherapy second-line program for relapsed and refractory Hodgkin disease: analysis by intent to treat and development of a prognostic model. Blood. 2001;97(3):616–23.PubMedCrossRef
26.
Engert A, Ballova V, Haverkamp H, Pfistner B, Josting A, Duhmke E, et al. Hodgkin’s lymphoma in elderly patients: a comprehensive retrospective analysis from the German Hodgkin’s Study Group. J Clin Oncol. 2005;23(22):5052–60.PubMedCrossRef
27.
Boll B, Gorgen H, Fuchs M, von Tresckow B, Engert A, Borchmann P. Feasibility and efficacy of ABVD in elderly Hodgkin lymphoma patients: analysis of two randomized prospective multicenter trials of the German Hodgkin Study Group (HD10 and HD11). ASH annual meeting abstracts. 2010 November 19, 2010;116(21):418.
28.
Boll B, Bredenfeld H, Gorgen H, Halbsguth T, Eich HT, Soekler M, et al. Phase 2 study of PVAG (prednisone, vinblastine, doxorubicin, gemcitabine) in elderly patients with early unfavorable or advanced stage Hodgkin lymphoma. Blood. 2011;118(24):6292–8.PubMedCrossRef
29.
Proctor SJ, Wilkinson J, Jones G, Watson GC, Lucraft HH, Mainou-Fowler T, et al. Evaluation of treatment outcome in 175 patients with Hodgkin lymphoma aged 60 years or over: the SHIELD study. Blood. 2012;119(25):6005–15.PubMedCrossRef
30.
Santoro A, Bredenfeld H, Devizzi L, Tesch H, Bonfante V, Viviani S, et al. Gemcitabine in the treatment of refractory Hodgkin’s disease: results of a multicenter phase II study. J Clin Oncol. 2000;18(13):2615–9.PubMed
31.
Nogova L, Rudiger T, Engert A. Biology, clinical course and management of nodular lymphocyte-predominant hodgkin lymphoma. Hematology Am Soc Hematol Educ Program. 2006;2006:266–72.
32.
Nogova L, Reineke T, Brillant C, Sieniawski M, Rudiger T, Josting A, et al. Lymphocyte-predominant and classical Hodgkin’s lymphoma: a comprehensive analysis from the German Hodgkin Study Group. J Clin Oncol. 2008;26(3):434–9.PubMedCrossRef
33.
Nogova L, Reineke T, Eich HT, Josting A, Muller-Hermelink HK, Wingbermuhle K, et al. Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin’s lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol. 2005;16(10):1683–7.PubMedCrossRef
34.
Hoppe RT, Advani RH, Ai WZ, Ambinder RF, Aoun P, Bello CM, et al. Hodgkin lymphoma, version 2.2012 featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2012;10(5):589–97.PubMed
35.
Chen RC, Chin MS, Ng AK, Feng Y, Neuberg D, Silver B, et al. Early-stage, lymphocyte-predominant Hodgkin’s lymphoma: patient outcomes from a large, single-institution series with long follow-up. J Clin Oncol. 2010;28(1):136–41.PubMedCrossRef
36.
Eichenauer DA, Fuchs M, Pluetschow A, Klimm B, Halbsguth T, Boll B, et al. Phase 2 study of rituximab in newly diagnosed stage IA nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group. Blood. 2011;118(16):4363–5.PubMedCrossRef
37.
Jackson C, Sirohi B, Cunningham D, Horwich A, Thomas K, Wotherspoon A. Lymphocyte-predominant Hodgkin lymphoma—clinical features and treatment outcomes from a 30-year experience. Ann Oncol. 2010;21(10):2061–8.PubMedCrossRef
38.
Schulz H, Rehwald U, Morschhauser F, Elter T, Driessen C, Rudiger T, et al. Rituximab in relapsed lymphocyte-predominant Hodgkin lymphoma: long-term results of a phase 2 trial by the German Hodgkin Lymphoma Study Group (GHSG). Blood. 2008;111(1):109–11.PubMedCrossRef
39.
Horning S, Fanale M, De Vos S, Borchmann P, Illidge T, Engert A, et al. Defining a population of Hodgkin lymphoma patients for novel therapeutics: an international effort. Ann Oncol 2008;19(Suppl 4) (June):abstract 118.
40.
Younes A, Bartlett NL, Leonard JP, Kennedy DA, Lynch CM, Sievers EL, et al. Brentuximab vedotin (SGN-35) for relapsed CD30-positive lymphomas. N Engl J Med. 2010;363(19):1812–21.PubMedCrossRef
41.
Younes A, Gopal AK, Smith SE, Ansell SM, Rosenblatt JD, Savage KJ, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin’s lymphoma. J Clin Oncol. 2012;30(18):2183–9.PubMedCrossRef
42.
Rothe A, Sasse S, Goergen H, Eichenauer DA, Lohri A, Jager U, et al. Brentuximab vedotin for relapsed or refractory CD30+ hematologic malignancies: the German Hodgkin Study Group experience. Blood. 2012;120(7):1470–2.PubMedCrossRef
43.
Chen R, Palmer JM, Thomas SH, Tsai NC, Farol L, Nademanee A, et al. Brentuximab vedotin enables successful reduced-intensity allogeneic hematopoietic cell transplantation in patients with relapsed or refractory Hodgkin lymphoma. Blood. 2012;119(26):6379–81.PubMedCrossRef
44.
Gopal AK, Ramchandren R, O’Connor OA, Berryman RB, Advani RH, Chen R, et al. Safety and efficacy of brentuximab vedotin for Hodgkin lymphoma recurring after allogeneic stem cell transplantation. Blood. 2012;120(3):560–8.PubMedCrossRef
45.
Forero-Torres A, Fanale M, Advani R, Bartlett NL, Rosenblatt JD, Kennedy DA, et al. Brentuximab vedotin in transplant-naive patients with relapsed or refractory Hodgkin lymphoma: analysis of two phase I studies. Oncologist. 2012;17(8):1073–80.PubMedCrossRef
46.
Boll B, Borchmann P, Topp MS, Hanel M, Reiners KS, Engert A, et al. Lenalidomide in patients with refractory or multiple relapsed Hodgkin lymphoma. Br J Haematol. 2010;148(3):480–2.PubMedCrossRef
47.
Fehniger TA, Larson S, Trinkaus K, Siegel MJ, Cashen AF, Blum KA, et al. A phase 2 multicenter study of lenalidomide in relapsed or refractory classical Hodgkin lymphoma. Blood. 2011;118(19):5119–25.PubMedCrossRef
48.
Johnston PB, Inwards DJ, Colgan JP, Laplant BR, Kabat BF, Habermann TM, et al. A phase II trial of the oral mTOR inhibitor everolimus in relapsed Hodgkin lymphoma. Am J Hematol. 2010;85(5):320–4.PubMed
49.
Younes A, Sureda A, Ben-Yehuda D, Zinzani PL, Ong TC, Prince HM, et al. Panobinostat in patients with relapsed/refractory Hodgkin’s lymphoma after autologous stem-cell transplantation: results of a phase II study. J Clin Oncol. 2012;30(18):2197–203.PubMedCrossRef
Metadata
Title
Advances in the treatment of Hodgkin lymphoma
Authors
Dennis A. Eichenauer
Andreas Engert
Publication date
01-11-2012
Publisher
Springer Japan
Published in
International Journal of Hematology / Issue 5/2012
Print ISSN: 0925-5710
Electronic ISSN: 1865-3774
DOI
https://doi.org/10.1007/s12185-012-1199-2

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