Comparing second-line treatments for patients with relapsed classic Hodgkin lymphoma

This study aimed to compare autologous stem cell transplant (ASCT) and conventional chemotherapy (CT) as second-line treatments in patients with relapsed early-stage (ES), classical Hodgkin lymphoma (cHL).  

This study concluded that CT treatments may be a suitable second-line treatment option for patients with ES-cHL after relapse.  

ES, favorable, cHL is commonly treated with high-dose CT. For patients that relapse (disease returns), conventional CR or ASCT may be used as second-line treatments. ASCT is where healthy blood stem cells are taken from the patient's own body and transplanted to after treatments remove diseased or damaged bone marrow. 

It was unknown if CT or ASCT were suitable as second-line treatments for relapsed ES-cHL. 

This study involved 172 patients with relapse after treatment for ES-HL. Relapse mostly occurred after more than 12 months from the first treatment and predominantly with stage I to II disease. 49% of patients were treated with CT, 41% were treated with ASCT, 6% were treated with radiotherapy only and 2% were treated with supportive therapies as second-line treatment.  

68% of CT-treated patients were treated with bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP). 19% of patients were treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine). 13% of patients in the CT group were treated with other regimes.  

Patients aged over 60 years at relapse had shorter second progression-free survival (PFS) and 67% were treated with CT while 16% were treated with ASCT. Younger patients mostly received ASCT (54%).

There was no significant difference in the effectiveness of CT versus ASCT for second PFS. The 2-year second PFS rate was 94% for the CT group compared to 83.3% for the ASCT group.  

This study concluded that after standard treatment of ES-cHL, relapse mostly occurred after more than 12 months and that CT treatments such as BEACOPP may be a suitable second-line treatment option. 

This study was based on medical records. Information might have been missing. This might have affected the results.