Clinical Outcomes and Therapeutic Strategies of Hodgkin Lymphoma

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 4682

Special Issue Editor


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Guest Editor
Division of Hematology, Clinical Hospital Merkur, 10000 Zagreb, Croatia
Interests: Hodgkin lymphoma; diffuse large B cell lymphoma; chronic lymphocytic leukemia

Special Issue Information

Dear Colleagues,

In 1961, the National Institute of Health researchers devised a regimen consisting of mechlorethamine, vincristine, procarbazine, and prednisone (the MOPP regimen), which was able to cure about half of patients with Hodgkin lymphoma (HL). This was the first chemotherapy regimen to cure patients and a revolution in oncology, offering hope to millions of patients suffering from malignant neoplasms. However, we have made significant improvements in curing HL with novel regimens such as BEACOPPesc and ABVD. After years of research, we have seen also an overall survival benefit with the immunochemotherapy regimen brentuximab vedotin+AVD in advanced stages. HL is certainly a story of success, yet few patients represent unmet needs being refractory to or relapsing after first-line therapy. The incorporation of brentuximab vedotin in salvage regimens has improved the outcomes of these patients. As a last resort, allogeneic stem cell transplantation remains a valid strategy.

This Special Issue aims to share different experiences with HL, regardless of the line of treatment, pointing out the similarities and diversities of our approach to HL.

Both original articles and the state-of-art reviews are welcome.

As a Guest Editor, I hope that this Special Issue will follow the success of our treatment of HL.

Dr. Vibor Milunović
Guest Editor

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Keywords

  • Hodgkin lymphoma
  • ABVD protocol
  • BEACOPP protocol
  • hematopoietic stem cell transplantation
  • brentuximab vedotin
  • immune checkpoint inhibitors
  • long term survivor
  • quality of life
  • pediatrics

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Published Papers (2 papers)

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Research

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12 pages, 705 KiB  
Article
Reduced Corticosteroid Exposure Is Safe and Does Not Reduce Disease Control among Hodgkin Lymphoma Patients Treated with Escalated BEACOPP (eBEACOPP)
by Ida Hude Dragičević, Sandra Bašić-Kinda, Helena Markotić, Martina Morić-Perić, Dino Dujmović, Ivo Radman, Barbara Dreta, Snježana Dotlić, Ivana Ilić, Lea Galunić Bilić, Margareta Dobrenić, Marko Kralik and Igor Aurer
Medicina 2024, 60(3), 430; https://doi.org/10.3390/medicina60030430 - 2 Mar 2024
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Abstract
Background and Objectives: eBEACOPP is the most effective chemotherapy regimen for younger patients with early unfavorable (EU) and advanced-stage (AS) Hodgkin lymphoma (HL), albeit with significant toxicities. The 14-day/cycle prednisone course contributes to side effects, including osteoarticular events like avascular bone necrosis [...] Read more.
Background and Objectives: eBEACOPP is the most effective chemotherapy regimen for younger patients with early unfavorable (EU) and advanced-stage (AS) Hodgkin lymphoma (HL), albeit with significant toxicities. The 14-day/cycle prednisone course contributes to side effects, including osteoarticular events like avascular bone necrosis (AVN). Our center has been using eBEACOPP since 2009 for AS and 2014 for EU patients. In 2016, we reduced prednisone treatment to 7–10 days to lessen AVN risk. We analyzed the effects of this approach. Materials and Methods: We retrospectively collected data on patients who received at least two cycles of eBEACOPP for first-line HL treatment. Results: A total of 162 patients (33 EU, 129 AS) were included. Their median age was 31 (range 19–59 years), and 88 were males. A total of 94 patients received full corticosteroid courses, and 68 received reduced corticosteroid courses. The overall response rate (ORR) was 98%. Different corticosteroid dosings had no significant effect on ORR, febrile neutropenia episodes, or hospital admissions. After a median follow-up (mFU) of 58 months, the 5yPFS for the entire cohort was 98% vs. 95% for the standard course vs. the short corticosteroids course, respectively (p = 0.37), while the 5yOS was 98% vs. 99% for the standard course vs. short corticosteroids course, respectively (p = 0.87). In AS patients intended to be treated with six eBEACOPP cycles, 5yPFS and 5yOS were 100% vs. 97% and 100% vs. 99% for standard vs. short corticosteroid courses, respectively (p = 0.56 and p = 0.17). In EU patients, 5yPFS was 97% (standard) vs. 95% (short) (p = 0.98) and 5yOS 100% vs. 93.3% (p = 0.87). Osteoarticular events were numerically lower in patients receiving the shorter prednisone course, both in the whole cohort and in the subgroup of patients treated with six cycles of eBEACOPP, but this difference failed to reach statistical significance. Conclusions: eBEACOPP provides excellent and durable first-line disease control. Shortening the corticosteroid course does not compromise efficacy, potentially reducing toxicity. However, longer follow-ups and larger studies are needed for confirmation. Full article
(This article belongs to the Special Issue Clinical Outcomes and Therapeutic Strategies of Hodgkin Lymphoma)
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Review

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19 pages, 1057 KiB  
Review
How I Follow Hodgkin Lymphoma in First Complete (Metabolic) Remission?
by Vibor Milunović
Medicina 2024, 60(2), 344; https://doi.org/10.3390/medicina60020344 - 19 Feb 2024
Viewed by 2492
Abstract
Hodgkin lymphoma is characterized by a high cure rate in the modern era of medicine regardless of stage, but patients suffer from a high risk of comorbidity associated with the administered therapy. The main aim of this review article is to assess and [...] Read more.
Hodgkin lymphoma is characterized by a high cure rate in the modern era of medicine regardless of stage, but patients suffer from a high risk of comorbidity associated with the administered therapy. The main aim of this review article is to assess and analyze the various comorbidities associated with Hodgkin lymphoma and address the survivorship of patients, including fertility, secondary cancers due to cardiovascular toxicity, and quality of life. Furthermore, this review explores the optimal strategy for detecting relapse. The treatment paradigm of Hodgkin lymphoma has shifted, with a paradigm shift toward achieving a high cure rate and low toxicity as a standard of care in this patient population. Checkpoint inhibitors, especially nivolumab, in combination with chemotherapy are increasingly being studied in the first line of therapy. However, their long-term toxicity remains to be assessed in longer follow-up. In conclusion, Hodgkin lymphoma survivors, regardless of their treatment, should be followed up individually by a multidisciplinary survivorship team in order to detect and properly treat the long-term side effects of therapy. Full article
(This article belongs to the Special Issue Clinical Outcomes and Therapeutic Strategies of Hodgkin Lymphoma)
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