Reviewing treatment options for very high-risk HL

This article reviewed the treatment options for patients with very high-risk Hodgkin’s lymphoma (HL).

Although aggressive lymphomas are sensitive to chemotherapy, many patients do not respond well to first-line treatment. Many patients with Hodgkin’s lymphoma may develop disease progression or relapse after first-line treatment. The best management approach for these high-risk patients remains under debate.

70% of patients diagnosed with advanced-stage Hodgkin’s lymphoma achieve long-term remission. However, 10% – 30% experience disease progression or relapse after first-line treatment. For these patients, high-dose chemotherapy followed by SCT is considered the best available option. 30% – 80% of patients can be successfully treated with this approach.

Patients who fail SCT may be candidates for allogeneic SCT (alloSCT). This procedure requires a matching stem cell donor. Previous studies reported average progression-free survival (time from treatment until disease progression) rates from 20% – 42% after this treatment. Overall survival (time from treatment until death from any cause) rates ranged from 25% – 57%.

For patients who do not respond to these therapies, antibody therapies may be another option. These include brentuximab vedotin (Adcetris), nivolumab (Opdivo) and pembrolizumab (Keytruda). This type of treatment helps the body’s immune system attack only cancer cells, leaving healthy cells alone.

This article reviewed the treatment options for very high-risk lymphomas, such as refractory Hodgkin’s lymphoma.