In a nutshell
This review aims to provide guidelines for the management of nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL).
Some background
Nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) is an uncommon type of Hodgkin lymphoma (HL). It accounts for around 5% of HL cases. The outcomes are usually favorable but late relapses and large cell transformation can occur. NLPHL related deaths are uncommon but treatment toxicity has been a cause of death. Past treatments have copied those for classical HL (cHL).
Because of the rarity of NLPHL, trials remain a challenge. Classical HL treatments have been used although they may not be the best option. It is important to review treatment options for NLPHL.
Methods & findings
This review involved data from articles over the past 20 years on treatments for NLPHL.
In patients with stage IA NLPHL involving a single node should be treated with either complete excision only or radiotherapy (RT) of the involved site. In children with a complete excision, observation is recommended. In those without complete excision, AV-PC (doxorubicin, vincristine, prednisone, and cyclophosphamide) chemotherapy is recommended.
In adults with stage IA-IIA (early-stage) NLPHL without complete excision, RT of the involved site is recommended. Rituximab (R; Rituxan) treatment alone is usually not recommended for a definitive first-line treatment of early-stage NLPHL.
Chemotherapy combinations such as ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), R-ABVD, or R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy, with or without RT are recommended for patients with stage III NLPHL. The use of RT alone in these patients is not recommended.
In patients with a localized relapse of NLPHL, treatment should be given according to initial therapy. RT of the involved site alone can be used, if RT was not given previously to the site of relapse. R, chemotherapy, or a combination of these can also be used.
The bottom line
This article reviewed treatment options for patients with NLPHL.
Published By :
Leukemia & lymphoma
Date :
Dec 04, 2020
