Hodgkin Lymphoma: Relapsed/Refractory
The term “relapsed” refers to disease that reappears or grows again after a period of The absence of disease. Remission does not necessarily indicate that a person is cured. Patients may have complete or partial remission..
The term “A cancer that is resistant to treatment.” is used to describe when the lymphoma does not respond to treatment (meaning that the Abnormal cell growth that cannot be controlled by the body's natural defenses. Cancerous cells can grow and eventually form tumors. cells continue to grow) or when the response to treatment does not last very long.
For classical HL, most relapses typically occur within the first three years following diagnosis, although some relapses occur much later. For patients who A disease that reappears or grows again after a period of remission. or become refractory, secondary therapies are often successful in providing another remission and may even There are no signs or symptoms of lymphoma, and a significant period of time (usually defined by years) has passed during which there are no relapses. the disease.
A number of treatment options are available for patients with relapsed or refractory HL. The type of treatment prescribed for individual patients depends on several factors, including the timing of the relapse, age and overall health of the patient, scope of disease, and previous therapies received.
The current standard secondary treatment for the majority of patients consists of combination therapy, usually followed by A type of bone marrow or stem cell transplantation in which a patient receives his or her own cells. stem cell transplantation (in which a patient’s own stem cells are used). Involved site The use of radiation beams (X-rays) to treat a cancer. (ISRT) may also be used.
Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. A transplant of bone marrow or stem cells is needed to restore healthy bone marrow. To learn more about stem cell transplantation, download the Understanding the Stem Cell Transplantation Process booklet.
There are a variety of single-agent and combination therapy regimens that may be used for relapsed/refractory HL, including:
- Brentuximab vedotin (Adcetris)
- Bendamustine (Treanda)
- Nivolumab (Opdivo)
- Pembrolizumab (Keytruda)
- DHAP (dexamethasone, cisplatin, and cytarabine)
- ESHAP (etoposide, methylprednisolone, cisplatin, and cytarabine)
- GVD (gemcitabine, vinorelbine, and liposomal doxorubicin)
- ICE (ifosfamide, carboplatin, and etoposide)
- IGEV (ifosfamide, gemcitabine, and vinorelbine)
Treatments Under Investigation
Although the cure rate in HL is already high, research continues to look for ways to treat the minority of patients who are refractory to treatment and those who relapse. Many promising therapies are currently under investigation in clinical trials for HL including:
- Anti-CD30-CAR T cells
- Atezolizumab (Tecentriq)
- Bortezomib (Velcade)
- Carfilzomib (Kyprolis)
- Everolimus (Afinitor)
- Ibrutinib (Imbruvica)
- Lenalidomide (Revlimid)
- Mocetinostat (MGCD0103)
- Ruxolitinib (Jakafi)