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SOHO State of the Art Updates and Next Questions: Hodgkin Lymphoma

Until recently, advances in classical Hodgkin lymphoma (HL) treatment primarily consisted of minor modifications of highly effective decades-old chemotherapy and radiation approaches. In early stage disease, excellent outcomes have been reported with fewer cycles of chemotherapy, lower doses and smaller radiation fields, and in some circumstances radiation elimination. In advanced stage disease, maintaining dose intensity of standard chemotherapy regimens has resulted in modest improvements in outcomes.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Review Article Source Type: research

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Conclusions Low-dose RT, administered to all sites of original involvement, was associated with improved progression-free survival, even in the setting of a metabolic CR after ABVD. Teaser The role of consolidation radiation therapy (RT) in advanced Hodgkin lymphoma is controversial, especially if a complete response (CR) is achieved by PET-CT after chemotherapy. In this series, low-dose (∼20 Gy) RT to all sites of original disease improved progression-free survival, even in the setting of a CR after ABVD. Long-term toxicity was similar between chemotherapy and combined modality therapy.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
The role of consolidation radiation therapy (RT) in advanced Hodgkin lymphoma is controversial, especially if a complete response (CR) is achieved according to positron emission tomography-computed tomography imaging after chemotherapy. In this series, low-dose (approximately 20 Gy) RT to all sites of original disease improved progression-free survival, even in the setting of a CR after ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine). Long-term toxicity was similar between chemotherapy and combined modality therapy.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Tags: Original Study Source Type: research
Conclusion Our results suggest that achievement of a CR is imperative in patients with advanced ENKL, and is desirable for any patient for whom auto-SCT is utilized. SMILE-based chemotherapy appeared effective in attaining a CR, and was also an effective salvage regimen. For patients attaining a first CR, auto-SCT should be strongly considered, but should definitely be utilized in patients attaining CR2. For patients with refractory disease, allo-SCT can be considered in a selected group of patients. Micro-Abstract We present a cohort of primarily non-Asian patients with advanced stage and relapsed/refractory ENKL. Our res...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion In older patients (age ≥ 60 years) with stage I/II HL, the combination of CT plus consolidative RT resulted in improved OS compared with monotherapy. However, the use of combination therapy in this age group seems suboptimal. This could be, in part, secondary to comorbidities limiting the use of CT plus RT in the elderly. Micro-Abstract Early-stage Hodgkin lymphoma is a highly curable malignancy. However, the outcomes for elderly patients have remained suboptimal. We conducted a retrospective study using the National Cancer Database to assess the therapies used for elderly patients with early-stage Hodgk...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusion CNS-directed high-dose chemotherapy and ASCT provides durable remission for patients with synchronous aggressive lymphoma and should be strongly considered as consolidative therapy for eligible patients with systemic NHL with CNS involvement in first complete remission. Micro-Abstract Systemic non-Hodgkin lymphoma with synchronous central nervous system involvement traditionally carries a poor prognosis. We found encouraging results with the use of high-dose chemotherapy and autologous stem cell transplantation as consolidation for patients in first complete remission. Central nervous system-directed conditionin...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Publication date: Available online 15 November 2017 Source:Clinical Lymphoma Myeloma and Leukemia Author(s): Matthew Mei, Robert Chen Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and ∼90% of patients who present with early-stage (stage I-II) disease and 70% of patients who present with late-stage disease will be cured with standard frontline treatment. For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy, followed by autologous transplantation (autoSCT). Although this approach will cure a significant proportion of patients, upto 5...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Hodgkin lymphoma (HL) is a highly curable B-cell lymphoma, and approximately 90% of patients who present with early stage (I-II) disease (1) and 70% of patients who present with late-stage disease will be cured with standard frontline treatment(2). For patients with relapsed or refractory (r/r) disease after initial therapy, the standard of care is salvage chemotherapy followed by autologous transplant (autoSCT). While this approach will cure a significant proportion of patients, up to 50% of patients will experience disease progression after autoSCT(3), and this population has historically had a very poor prognosis.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
Extra-nodal natural killer/T-cell lymphoma (ENKL) is a rare lymphoma representing approximately 5-10% of T-cell non-Hodgkin lymphomas diagnosed in the United States each year.1, 2 ENKL is universally associated with Epstein-Barr virus (EBV) infection, and is more frequent in Asian, Central American and South American populations, where it constitutes 5-15% of all lymphomas.3-5 Patients with advanced stage ENKL (stage III-IV) and relapsed/refractory early stage disease are treated with systemic chemotherapy with or without radiotherapy.
Source: Clinical Lymphoma, Myeloma and Leukemia - Category: Hematology Authors: Source Type: research
Conclusion The use of RT in NLPHL is less likely among those with advanced-stage and B-symptoms. However, we found RT to be associated with prolonged OS in all stages of NLPHL, including those with B-symptoms. Teaser We assessed the role of radiotherapy (RT) in nodular lymphocytic Hodgkin lymphoma (NLPHL), particularly among patients with advanced stage disease, and B symptoms. We found that among NLPHL patients, RT had a potential role in advanced-stage disease and those with B symptoms, suggesting further exploratory studies.
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
Conclusions In older patients (≥60 years) with stage I/II HL, combination of chemotherapy and consolidative radiation resulted in improved OS as compared to monotherapy. However, utilization of combination therapy in this age group seems suboptimal. It could be partly secondary to comorbidities limiting the use of CT+RT in elderly. Teaser Early stage Hodgkin lymphoma is a highly curable malignancy. However, outcomes for elderly patients remain suboptimal. We conducted a retrospective study using the National Cancer Database to assess therapies used among elderly patients with early stage Hodgkin lymphoma from 2004-2012....
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research
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