Classical Hodgkin Lymphoma: When Second-Line Therapy Does Not Achieve Complete Remission

This protocol applies to adults with classical Hodgkin lymphoma (cHL) that is relapsed or refractory, and in whom second-line therapy has not achieved the required degree of response.

Clinical Scenario

Relapsed cHL means the disease has returned after a period of remission. Refractory cHL means the disease has not responded to prior treatment. Even in this clinical situation, the disease may still be potentially curable.

When Second-Line Therapy Has Not Worked

Second-line regimens — including BeGEV, brentuximab vedotin-based combinations, DHAP, GVD, ICE-based combinations, IGEV, and pembrolizumab-based regimens — aim to achieve complete disease remission with a negative PET-CT response (Deauville score of 1, 2, or 3).

When that goal is not reached, this protocol defines the structured clinical step that follows.

Next-Line Approach

The standard approach for this situation involves autologous stem cell transplantation — a procedure that uses stem cells collected from the patient themselves. This remains the standard therapy for relapsed and refractory cHL. The full protocol details the complete regimen and eligibility pathway.

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.

Autologous stem cell transplantation — a procedure in which stem cells are removed from a patient, frozen and stored, and then returned to the patient's bloodstream after the patient has had intensive chemotherapy.

In almost all cases, this is the type of stem cell transplantation used to treat HL. It remains the standard therapy for relapsed and refractory cases of HL.

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