Treatment of Classical Hodgkin Lymphoma That Is Relapsed or Refractory After First-Line Therapy

This protocol applies to adults with classical Hodgkin lymphoma (cHL) whose disease has either relapsed after an initial remission, or is refractory — meaning it did not respond to first-line treatment. In both situations, classical Hodgkin lymphoma remains potentially curable.

Clinical Scenario

Relapse means the disease has returned after a period of remission following treatment. Refractory disease has not responded to treatment at all. Both situations call for a distinct, structured therapeutic approach.

Treatment Approach

Second-line therapy is indicated. The available options span several categories — including established chemotherapy combinations, antibody-drug conjugate therapy, and checkpoint inhibitor-based regimens. The full protocol specifies the individual options and how they apply to this clinical setting.

Treatment Goal

The primary target is complete disease remission confirmed by a negative PET-CT response, defined as a Deauville score of 1, 2, or 3 — indicating no areas of concern on imaging.

Instant Access to Structured Evidence-Based Regimens

References

Relapse means the disease comes back after a remission following treatment. Refractory means the disease has not responded to treatment.
For patients whose disease is relapsed or refractory, HL is still potentially curable.
When patients are not cured with initial therapy, second-line treatment options include: Alternate chemotherapy combinations, Antibody-drug conjugate therapy with brentuximab vedotin, Checkpoint inhibitors, such as nivolumab or pembrolizumab, Autologous stem cell transplantation.
A score of 1, 2 or 3 is considered negative, meaning there are no areas of concern.

View source ↗