Relapsed Hodgkin lymphoma
In some cases, Hodgkin lymphoma may return, even after patients have achieved a remission. The return of the disease is referred to as a "relapse" or "relapsed disease." For these patients, Hodgkin lymphoma is still potentially curable. Treatment for these patients patients usually includes additional chemotherapy and drug therapy. The treatment often gives patients very long disease-free periods.
Refractory Hodgkin lymphoma
A small percentage of patients have disease that either does not respond or is resistant to initial treatment. This is called “refractory” HL. Approximately 10 percent of patients with early-stage HL and 20 to 30 percent of patients who have advanced disease either respond briefly and then their disease relapses, or they do not respond at all to standard chemotherapy combinations, and these patients experience progression of the disease. These patients often require further treatment which typically consists of high-dose chemotherapy followed by autologous (using the patient’s own cells) stem cell transplantation (SCT).
Treatment of Relapsed or Refractory Hodgkin Lymphoma
The following are treatments approved for relapsed and refractory Hodgkin lymphoma
- Further chemotherapy is given, such as
- ICE (ifosfamide, carboplatin, etoposide)
- DICE (dexamethasone, ifosfamide, cisplatin, etoposide)
- ESHAP (etoposide, methylprednisolone, Ara-C, cisplatin)
- GND (gemcitabine [Gemzar®], Navelbine® [vinorelbine], Doxil® [liposomal doxorubicin])
- Brentuximab vedotin (Adcetris, either alone or in combination with chemotherapy or other agents)
- Stem cell transplantation
- Nivolumab (Opdivo®)
- Pembrolizumab (Keytruda®)