Advertisement

Hodgkin’s Lymphoma

  • Jason Chan
  • Steve E. Braunstein
Chapter

Abstract

This chapter will discuss the epidemiology, workup, and management of Hodgkin’s lymphoma, with an emphasis on external beam radiotherapy technique and published evidence.

Keywords

Hodgkin’s Lymphoma 

Notes

Acknowledgment

We thank Hans T. Chung MD, Stephen L. Shiao MD, PhD, and Naomi R. Schechter MD for their work on the prior edition of this chapter.

References

  1. Advani R, Maeda L, Lavori P, et al. Impact of positive positron emission tomography on prediction of freedom from progression after Stanford V chemotherapy in Hodgkin’s disease. J Clin Oncol. 2007;25(25):3902–7.CrossRefGoogle Scholar
  2. Advani R, Horning SJ, Jonathan E, et al. Abbreviated 8-week chemotherapy (CT) plus involved node radiotherapy (INRT) for nonbulky stage I-II Hodgkin lymphoma: preliminary results of the Stanford G5 Study. J Clin Oncol (Meeting abstracts). 2011;29:8064.CrossRefGoogle Scholar
  3. Aleman BM, Raemaekers JM, Tomasic R, et al. Involved field radiotherapy for patients in partial remission after chemotherapy for advanced Hodgkin’s lymphoma. Int J Radiat Oncol Biol Phys. 2007;67(1):19–30.CrossRefGoogle Scholar
  4. Aleman BMP, Raemaekers JMM, Tirelli U, et al. Involved-field radiotherapy for advanced Hodgkin’s lymphoma. N Engl J Med. 2003;348:2396–406.CrossRefGoogle Scholar
  5. Bonadonna G, Bonfante V, Viviani S, Di Russo A, Villani F, Valagussa P. ABVD plus subtotal nodal versus involved-field radiotherapy in early-stage Hodgkin’s disease: long-term results. J Clin Oncol. 2004;22(14):2835–41.CrossRefGoogle Scholar
  6. Borchmann P, Haverkamp H, Diehl V, et al. Eight cycles of escalated-dose BEACOPP compared with four cycles of escalated-dose BEACOPP followed by four cycles of baseline-dose BEACOPP with or without radiotherapy in patients with advanced-stage Hodgkin’s lymphoma: final analysis of the HD12 trial of the German Hodgkin Study Group. J Clin Oncol. 2011;29:4234–42.CrossRefGoogle Scholar
  7. Borchmann P, Haverkamp H, Diehl V, et al. Eight cycles of escalated-dose BEACOPP compared with four cycles of escalated-dose BEACOPP followed by four cycles of baseline-dose BEACOPP with or without radiotherapy in patients with advanced-stage Hodgkin’s lymphoma: final analysis of the HD12 trial of the German Hodgkin Study Group. J Clin Oncol. 2011;29:4234–42.CrossRefGoogle Scholar
  8. Borchmann P, Haverkamp H, Lohri A, et al. Addition of rituximab to BEACOPP escalated to improve the outcome of early interim PET positive advanced stage Hodgkin lymphoma patients: second planned interim analysis of the HD18 study. Blood (Meeting abstracts). 2014;124:500.Google Scholar
  9. Canellos GP, Anderson JR, Propert KJ, et al. Chemotherapy of advanced Hodgkin’s disease with MOPP, ABVD, or MOPP alternating with ABVD. N Engl J Med. 1992;327:1478–84.CrossRefGoogle Scholar
  10. Canellos GP, Niedzwiecki D. Long-term follow-up of Hodgkin’s disease trial. N Engl J Med. 2002;346:1417–8.CrossRefGoogle Scholar
  11. Diefenbach CS, Li H, Hong F, et al. Evaluation of the International Prognostic Score (IPS-7) and a Simpler Prognostic Score (IPS-3) for advanced Hodgkin lymphoma in the modern era. Br J Haematol. 2015;171:530–8.CrossRefGoogle Scholar
  12. Diehl V, Brillant C, Engert A, et al. HD10: investigating reduction of combined modality treatment intensity in early stage Hodgkin’s lymphoma. Interim analysis of a randomized trial of the German Hodgkin Study Group (GHSG). J Clin Oncol (Meeting abstracts). 2005a;23:6506.CrossRefGoogle Scholar
  13. Diehl V, Brillant C, Engert A, et al. Recent interim analysis of the HD11 trial of the GHSG: intensification of chemotherapy and reduction of radiation dose in early unfavorable stage Hodgkin’s lymphoma. Blood. 2005b;106:abstract no. 816.Google Scholar
  14. Diehl V, Franklin J, Pfistner B, et al. Ten-year results of a German Hodgkin Study Group randomized trial of standard and increased dose BEACOPP chemotherapy for advanced Hodgkin lymphoma (HD9). J Clin Oncol (Meeting abstracts). 2007a;25:LBA8015.Google Scholar
  15. Diehl V, Franklin J, Pfreundschuh M, et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin’s disease. NEJM. 2003;348:2386–95.CrossRefGoogle Scholar
  16. Diehl V, Franklin J, Tesch H, et al. Dose escalation of BEACOPP chemotherapy for advanced Hodgkin’s disease in the HD9 trial of the German Hodgkin’s Lymphoma Study Group (GHSG). Proc ASCO. 2007;8544:(abstract no. 7).Google Scholar
  17. Diehl V, Haverkamp H, Mueller R, et al. Eight cycles of BEACOPP escalated compared with 4 cycles of BEACOPP baseline with or without radiotherapy in patients in advanced stage Hodgkin lymphoma (HL): final analysis of the HD12 trial of the Germa Hodgkin Study Group (GHSG). J Clin Oncol. 2009;27:15s (Suppl; abstr 8544)Google Scholar
  18. Diehl V, Loeffler M, Pfreundschuh M, et al. Further chemotherapy versus low-dose involved-field radiotherapy as consolidation of complete remission after six cycles of alternating chemotherapy in patients with advance Hodgkin’s disease. German Hodgkins’ Study Group (GHSG). Ann Oncol. 1995;6(9):901–10.CrossRefGoogle Scholar
  19. Eich H, Gossmann A, Engert A, et al. A contribution to solve the problem of the need for consolidative radiotherapy after intensive chemotherapy in advanced stages of Hodgkin’s lymphoma – analysis of a quality control program initiated by the radiotherapy reference Center of the German Hodgkin Study Group (GHSG). Int J Radiat Oncol Biol Phys. 2007;69:1187–92.CrossRefGoogle Scholar
  20. Eich HT, Diehl V, Gorgen H, et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin’s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol. 2010;28:4199–206.CrossRefGoogle Scholar
  21. Eichenauer DA, Plütschow A, Fuchs M, von Tresckow B, Böll B, Behringer K, Diehl V, Eich HT, Borchmann P, Engert A. Long-term course of patients with stage IA nodular lymphocyte-predominant Hodgkin lymphoma: a report from the German Hodgkin Study Group. J Clin Oncol. 2015;33(26):2857–62.CrossRefGoogle Scholar
  22. Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A, Zijlstra J, Král Z, Fuchs M, Hallek M, Kanz L. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin’s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet. 2012;379(9828):1791–9.CrossRefGoogle Scholar
  23. Engert A, Diehl V, Franklin J, et al. Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin’s lymphoma: 10 years of follow-up of the GHSG HD9 study. J Clin Oncol. 2009;27(27):4548–54.CrossRefGoogle Scholar
  24. Engert A, Franklin J, Eich HT, et al. Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin’s lymphoma: final results of the GHSG HD7 trial. J Clin Oncol. 2007;25(23):3495–502.CrossRefGoogle Scholar
  25. Engert A, Plütschow A, Eich HT, et al. Reduced treatment intensity in patients with early-stage Hodgkin’s lymphoma. N Engl J Med. 2010;363:640–52.CrossRefGoogle Scholar
  26. Engert A, Schiller P, Josting A, Herrmann R, Koch P, Sieber M, Boissevain F, de Wit M, Mezger J, Dühmke E, Willich N. Involved-field radiotherapy is equally effective and less toxic compared with extended-field radiotherapy after four cycles of chemotherapy in patients with early-stage unfavorable Hodgkin’s lymphoma: results of the HD8 trial of the German Hodgkin’s Lymphoma Study Group. J Clin Oncol. 2003;21 (19):3601–8.CrossRefGoogle Scholar
  27. Fabian CJ, Mansfield CM, Dahlberg S, et al. Low-dose involved field radiation after chemotherapy in advanced Hodgkin disease. A Southwest Oncology Group randomized study. Ann Intern Med. 1994;120(11):903–12.CrossRefGoogle Scholar
  28. Ferme C, Eghbali H, Meerwaldt JH, et al. Chemotherapy plus involved-field radiation in early-stage Hodgkin’s disease. N Engl J Med. 2007;357(19):1916–27.CrossRefGoogle Scholar
  29. Firme C, Sebban C, Hennequin C, et al. Comparison of chemotherapy to radiotherapy as consolidation of complete or good partial response after six cycles of chemotherapy for patients with advanced Hodgkin’s disease: results of the Groupe d’etudes des Lymphomes de l’Adulte H89 trial. Blood. 2000;95:2246–52.Google Scholar
  30. Gallmini A, Hutchings M, Rigacci L, et al. Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol. 2007;25:3746–52.CrossRefGoogle Scholar
  31. Girinsky T, Specht L, Ghalibafian M, et al. The conundrum of Hodgkin lymphoma nodes: to be or not to be included in the involved node radiation fields. The EORTC-GELA lymphoma group guidelines. Radiother Oncol. 2008;88:202–10.CrossRefGoogle Scholar
  32. Gobbi PG, Levis A, Chisesi T, et al. ABVD versus modified Stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced stage Hodgkin’s lymphoma. Final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi. J Clin Oncol. 2005;23:9198–207.CrossRefGoogle Scholar
  33. Hasenclever D, Diehl V, Armitage JO, et al. A prognostic score for advanced Hodgkin’s disease. N Engl J Med. 1998;339:1506–14.CrossRefGoogle Scholar
  34. Hay AE, Klimm B, Chen BE, Goergen H, Shepherd LE, Fuchs M, Gospodarowicz MK, Borchmann P, Connors JM, Markova J, Crump M. An individual patient-data comparison of combined modality therapy and ABVD alone for patients with limited-stage Hodgkin lymphoma. Ann Oncol. 2013;24(12):3065–9.CrossRefGoogle Scholar
  35. Horning SJ, Hoppe RT, Advani R, et al. Efficacy and late effects of Stanford V chemotherapy and radiotherapy in untreated Hodgkin’s disease: mature data in early and advanced stage patients. Blood. 2004;104:308 (abstr 308).Google Scholar
  36. Johnson PW, Sydes MR, Hancock BW, Cullen M, Radford JA, Stenning SP. Consolidation radiotherapy in patients with advanced Hodgkin’s lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519). J Clin Oncol. 2010;28(20):3352–9.CrossRefGoogle Scholar
  37. Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the imaging subcommittee on International Harmonization Project in Lymphoma. J Clin Oncol. 2007;25(5):571–8.CrossRefGoogle Scholar
  38. Khan N, Khan MK, Almasan A, Singh AD, Macklis R. The evolving role of radiation therapy in the management of malignant melanoma. Int J Radiat Oncol Biol Phys. 2011;80(3):645–54.CrossRefGoogle Scholar
  39. Kobe C, Dietlein M, Franklin J, et al. FDG-PET for assessment of residual tissue after completion of chemotherapy in Hodgkin lymphoma – report on the second interim analysis of the PET investigation in the trial HD15 of the GHSG. Haematol. 2007;92(Suppl 5):CO21.Google Scholar
  40. Laskar S, Gupta T, Vimal S, et al. Consolidation radiation after complete remission in Hodgkin’s disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? J Clin Oncol. 2004;22:62–8.CrossRefGoogle Scholar
  41. Lavoie JC, Connors JM, Phillips GL, et al. High-dose chemotherapy and autologous stem cell transplantation for primary refractory or relapsed Hodgkin lymphoma: long-term outcome in the first 100 patients treated in Vancouver. Blood. 2005;106(4):1473–8.CrossRefGoogle Scholar
  42. Levis M, Piva C, Filippi AR, Botto B, Gavarotti P, Pregno P, Nicolosi M, Freilone R, Parvis G, Gottardi D, Vitolo U. Potential benefit of involved-field radiotherapy for patients with relapsed-refractory hodgkin’s lymphoma with incomplete response before autologous stem cell transplantation. Clin Lymphoma Myeloma Leuk. 2017;17(1):14–22.CrossRefGoogle Scholar
  43. Macdonald DA, Ding K, Gospodarowicz MK, et al. Patterns of disease progression and outcomes in a randomized trial testing ABVD alone for patients with limited-stage Hodgkin lymphoma. Ann Oncol. 2007;18(10):1680–4.CrossRefGoogle Scholar
  44. Marks LB, Yorke ED, Jackson A, et al. Use of normal tissue complication probability models in the clinic. Int J Radiat Oncol Biol Phys. 2010;76:S10–9.CrossRefGoogle Scholar
  45. Meyer RM, Gospodarowicz MK, Connors JM, et al. ABVD alone versus radiation-based therapy in limited-stage Hodgkin’s lymphoma. N Engl J Med. 2012;366:399–408.CrossRefGoogle Scholar
  46. Noordijk E, Carde P, Hagenbeek A. Combination of radiotherapy and chemotherapy is advisable in all patients with clinical stage I-II Hodgkin’s disease. Six-year results of the EORTC-GPMC controlled clinical trials “H7-VF”, “H7-F” and “H7-U”. Presented at ASTRO 1997.Google Scholar
  47. Noordijk EM, Thomas J, Ferme C, et al. First results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin’s lymphoma (HL). J Clin Oncol (Meeting abstracts). 2005;23:6505.CrossRefGoogle Scholar
  48. Noordijk EM, Carde P, Dupouy N, et al. Combined-modality therapy for clinical stage I or II Hodgkin’s lymphoma: long-term results of the European Organization for Research and Treatment of Cancer (EORTC) H7 randomized controlled trials. J Clin Oncol. 2006;24:3128–35.CrossRefGoogle Scholar
  49. Olszewski AJ, Shrestha R, Castillo JJ. Treatment selection and outcomes in early-stage classical Hodgkin lymphoma: analysis of the National Cancer Data Base. J Clin Oncol. 2015;33(6):625–33.CrossRefGoogle Scholar
  50. Pavlovsky S, Maschio M, Santarelli MT, et al. Randomized trial of chemotherapy versus chemotherapy plus radiotherapy for stage I–II Hodgkin’s disease. J Natl Cancer Inst. 1988;80(18):1466–73.CrossRefGoogle Scholar
  51. Picardi M, De Renzo A, Pane F, et al. Randomized comparison of consolidation radiation versus observation in bulky Hodgkin’s lymphoma with post-chemotherapy negative positron emission tomography scans. Leuk Lymphoma. 2007;48(9):1721–7.CrossRefGoogle Scholar
  52. Poen JC, Hoppe RT, Horning SJ. High-dose therapy and autologous bone marrow transplantation for relapsed/refractory Hodgkin’s disease: the impact of involved field radiotherapy on patterns of failure and survival. Int J Radiat Oncol Biol Phys. 1996;36(1):3–12.CrossRefGoogle Scholar
  53. Press OW, LeBlanc M, Lichter AS, et al. Phase III randomized intergroup trial of subtotal lymphoid irradiation versus doxorubicin, vinblastine, and subtotal lymphoid irradiation for stage IA to IIA Hodgkin’s disease. J Clin Oncol. 2001;19:4238–44.CrossRefGoogle Scholar
  54. Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-directed therapy for early-stage Hodgkin’s lymphoma. N Engl J Med. 2015;372:1598–607.CrossRefGoogle Scholar
  55. Raemaekers JMM, Andre MPE, Federico M, et al. Omitting radiotherapy in early positron emission tomography-negative stage I/II Hodgkin lymphoma is associated with an increased risk of early relapse: clinical results of the preplanned interim analysis of the randomized EORTC/LYSA/FIL H10 trial. J Clin Oncol. 2014;32:1188–94.CrossRefGoogle Scholar
  56. Rigacci L, Vitolo U, Nassi L, et al. Positron emission tomography in the staging of patients with Hodgkin’s lymphoma. Ann Hematol. 2007;86:897–903.CrossRefGoogle Scholar
  57. Schaapveld M, Aleman BMP, van Eggermond AM, et al. Second cancer risk up to 40 years after treatment for Hodgkin’s lymphoma. N Engl J Med. 2015;373:2499–511.CrossRefGoogle Scholar
  58. Shimabukuro-Vornhagen A, Haverkamp H, Engert A, et al. Lymphocyte-rich classical Hodgkin’s lymphoma: clinical presentation and treatment outcome in 100 patients treated within German Hodgkin’s Study Group trials. J Clin Oncol. 2005;23:5739–45.CrossRefGoogle Scholar
  59. Sickinger MT, von Tresckow B, Kobe C, et al. PET-adapted omission of radiotherapy in early stage Hodgkin lymphoma—a systematic review and meta-analysis. Crit Rev Oncol Hematol. 2016;101:86–92.CrossRefGoogle Scholar
  60. Sieber M, Franklin J, Tesch H. Two cycles ABVD plus extended field radiotherapy is superior to radiotherapy alone in early stage Hodgkin’s disease: results of the German Hodgkin’s Lymphoma Study Group (GHSG) trial HD7. Leuk Lymphoma. 2002;43(Suppl 2):52.Google Scholar
  61. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29.CrossRefGoogle Scholar
  62. Sieniawski M, Franklin J, Nogova L, et al. Outcome of patients experiencing progression or relapse after primary treatment with two cycles of chemotherapy and radiotherapy for early-stage favorable Hodgkin’s lymphoma. J Clin Oncol. 2007;25(15):2000–5.CrossRefGoogle Scholar
  63. Specht L, Gray RG, Clarke MJ, et al. Influence of more extensive radiotherapy and adjuvant chemotherapy on long-term outcome of early-stage Hodgkin’s disease: a meta-analysis of 23 randomized trials involving 3,888 patients. International Hodgkin’s Disease Collaborative Group. J Clin Oncol. 1998;16:830–43.CrossRefGoogle Scholar
  64. Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol. 2014;89:854–62.CrossRefGoogle Scholar
  65. Straus DJ, Portlock CS, Qin J, et al. Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. Blood. 2004;104:3483–9.CrossRefGoogle Scholar
  66. Thomas J, Ferme C, Noordijk EM, et al. EORTC lymphoma group; groupe d’études des lymphomes adultes (GELA). Results of the EORTC-GELA H9 randomized trials: the H9-F trial (comparing 3 radiation dose levels) and H9-U trial (comparing 3 chemotherapy schemes) in patients with favorable or unfavorable early stage Hodgkin’s lymphoma (HL). Haematologica. 2007;92(s5):27.Google Scholar
  67. van Nimwegen FA, Schaapveld M, Cutter DJ, et al. Radiation dose-response relationship for risk of coronary heart disease in survivors of Hodgkin lymphoma. J Clin Oncol. 2015;34(3):235–43.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Radiation OncologyUniversity of California San FranciscoSan FranciscoUSA

Personalised recommendations