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Salvage Therapy for Hodgkin's Lymphoma: A Review of Current Regimens and Outcomes

Overview
Journal J Blood Med
Publisher Dove Medical Press
Specialty Hematology
Date 2020 Nov 5
PMID 33149713
Citations 4
Authors
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Abstract

Relapse/refractory Hodgkin lymphoma patients are still a clinical concern. Indeed, despite more effective first-line chemotherapy regimens and better stratification of unresponsive patients by clinical factors and use of early PET, roughly one-third of such patients need salvage chemotherapy and consolidation with high-dose chemotherapy. In this paper, the authors review the different salvage treatments, with special emphasis on newer combinations with brentuximab vedotin or check point inhibitors. The overall response rate is constantly increasing, with a complete remission rate approaching 80%. Functional response evaluation by PET imaging is a strong predictive factor of longer survival, and more sophisticated tools, such as detection of circulating tumour DNA, are emerging to refine the disease-status assessment after treatment. Consolidation by high-dose chemotherapy is still considered the standard of care in chemosensitive patients, leading to a high fraction of patients towards long-term disease control. Maintenance therapy with BV is now approved, reducing disease relapse/progression. An increasing number of Hodgkin lymphoma patients will be cured after first- and second-line therapy, and long-term toxicity needs to be continuously assessed and avoided.

Citing Articles

Combination of Brentuximab Vedotin and Pembrolizumab as Salvage Treatment Before Autologous Stem Cell Transplantation and Maintenance in Patients with Relapsed/Refractory Hodgkin Lymphoma.

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PMID: 40002670 PMC: 11852501. DOI: 10.3390/biomedicines13020252.


Programmed Death 1 (PD-1) Expression in Relapsing and Remitting Hodgkin Lymphoma as Prognostic Factor.

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Safety and efficacy of immune checkpoint inhibitors after allogeneic hematopoietic cell transplantation.

Alkhaldi H, Kharfan-Dabaja M, El Fakih R, Aljurf M Bone Marrow Transplant. 2023; 58(10):1075-1083.

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The role of transplantation in Hodgkin lymphoma.

Maranzano M, Mead M Front Oncol. 2023; 12:1054314.

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Immune Checkpoint Blockade for the Treatment of Hodgkin Lymphoma.

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