Treatment of Classical Hodgkin's Lymphoma — Advanced Stage (Stage III or IV)
Clinical Scenario
Adults diagnosed with classical Hodgkin lymphoma at advanced stage — stage III or IV. Even at these advanced stages, Hodgkin's lymphoma is potentially curable.
Treatment Approach
Advanced-stage disease calls for more intensive combination chemotherapy, with involved-site radiation therapy (ISRT) considered in select cases. Several regimen options exist, with the choice guided by patient age and individual circumstances — the complete selection algorithm is in the full protocol.
Clinical Goals
Response is assessed by PET-CT at interim (after two cycles) and at end of therapy. A negative result — Deauville score of 1, 2, or 3 — indicates no areas of concern. The primary endpoint is complete disease remission.
References
- Even in advanced stages, HL is potentially curable.
- In general, patients with advanced-stage HL are treated with more intense regimens of combination chemotherapy.
- Occasionally, chemotherapy is followed by involved-site radiation therapy (ISRT).
- A PET scan is typically performed after two cycles of therapy (interim PET) and at the end of therapy.
- A score of 1, 2 or 3 is considered negative, meaning there are no areas of concern.