Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes
Luca Castagna,1 Armando Santoro,1,2 Carmelo Carlo-Stella1,2 1Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan 20089, Italy; 2Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan 20090, ItalyCorrespondence: Luca CastagnaHumanitas Clinical and Research Center, IR...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-10-01
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| Series: | Journal of Blood Medicine |
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| Online Access: | https://www.dovepress.com/salvage-therapy-for-hodgkinrsquos-lymphoma-a-review-of-current-regimen-peer-reviewed-article-JBM |
| _version_ | 1828270517877997568 |
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| author | Castagna L Santoro A Carlo-Stella C |
| author_facet | Castagna L Santoro A Carlo-Stella C |
| author_sort | Castagna L |
| collection | DOAJ |
| description | Luca Castagna,1 Armando Santoro,1,2 Carmelo Carlo-Stella1,2 1Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan 20089, Italy; 2Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan 20090, ItalyCorrespondence: Luca CastagnaHumanitas Clinical and Research Center, IRCCS, Via Manzoni 56, Rozzano, Milan 20089, ItalyEmail luca.castagna@humanitas.itAbstract: 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.Keywords: Hodgkin lymphoma, refractory/relapsed disease, checkpoint inhibitors, brentuximab vedotin, high-dose chemotherapy |
| first_indexed | 2024-04-13T05:44:03Z |
| format | Article |
| id | doaj.art-6cb70b1fef604ea78f07bfc252f6364d |
| institution | Directory Open Access Journal |
| issn | 1179-2736 |
| language | English |
| last_indexed | 2024-04-13T05:44:03Z |
| publishDate | 2020-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Blood Medicine |
| spelling | doaj.art-6cb70b1fef604ea78f07bfc252f6364d2022-12-22T03:00:00ZengDove Medical PressJournal of Blood Medicine1179-27362020-10-01Volume 1138940358499Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and OutcomesCastagna LSantoro ACarlo-Stella CLuca Castagna,1 Armando Santoro,1,2 Carmelo Carlo-Stella1,2 1Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan 20089, Italy; 2Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan 20090, ItalyCorrespondence: Luca CastagnaHumanitas Clinical and Research Center, IRCCS, Via Manzoni 56, Rozzano, Milan 20089, ItalyEmail luca.castagna@humanitas.itAbstract: 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.Keywords: Hodgkin lymphoma, refractory/relapsed disease, checkpoint inhibitors, brentuximab vedotin, high-dose chemotherapyhttps://www.dovepress.com/salvage-therapy-for-hodgkinrsquos-lymphoma-a-review-of-current-regimen-peer-reviewed-article-JBMhodgkin lymphomarefractory/relapsed diseasecheckpoint inhibitorsbrentuximab vedotinhigh-dose chemotherapy |
| spellingShingle | Castagna L Santoro A Carlo-Stella C Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes Journal of Blood Medicine hodgkin lymphoma refractory/relapsed disease checkpoint inhibitors brentuximab vedotin high-dose chemotherapy |
| title | Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes |
| title_full | Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes |
| title_fullStr | Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes |
| title_full_unstemmed | Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes |
| title_short | Salvage Therapy for Hodgkin’s Lymphoma: A Review of Current Regimens and Outcomes |
| title_sort | salvage therapy for hodgkin rsquo s lymphoma a review of current regimens and outcomes |
| topic | hodgkin lymphoma refractory/relapsed disease checkpoint inhibitors brentuximab vedotin high-dose chemotherapy |
| url | https://www.dovepress.com/salvage-therapy-for-hodgkinrsquos-lymphoma-a-review-of-current-regimen-peer-reviewed-article-JBM |
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