Onkologie. 2011:5(5):294-296

Reduction of toxicity in first-line treatment of advanced stage Hodgkin lymphoma

Jana Marková

Oddělení klinické hematologie, Fakultní nemocnice Královské Vinohrady, Praha

Hodgkin lymphoma (HL) is one of the best curable malignant diseases. Modern therapeutic strategies can cure 85–95 % of patients. Late

effects have become increasingly important, especially cardiotoxicity and second tumors, that cause more deaths than HL 15 years after

completion of treatment. The goal of the research is to find the therapy that maximizes tumor control and minimizes acute and longterm

toxicity. German Hodgkin Study Group (GHSG) proved the possibility to reduce chemotherapy and radiotherapy without reducing

the effectiveness of treatment in the HD10 study for early stages of HL. HD9 study for advanced stages demonstrated excellent results

of BEACOPP escalated chemotherapy compared to the conventional therapy ABVD, but BEACOPP escalated induced higher acute and

long-term toxicity. The goal of subsequent GHSG studies for advanced stages (HD12, HD15 and ongoing active HD18 study) is to reduce

the intensity of chemotherapy and to evaluate the significance of subsequent radiotherapy. The HD15 study tests the significance of

FDG-PET for indication of radiotherapy. Current HD18 study tests by FDG-PET the early response of tumor after 2 cycles of chemotherapy.

New biological drugs that target receptors on malignant cells (monoclonal antibodies, inhibitors) are awaited.

Keywords: Hodgkin lymphoma, advanced stage, BEACOPP escalated, FDG-PET, late effects

Published: November 1, 2011  Show citation