Salvage regimens for Hodgkin lymphoma

There are many effective salvage chemotherapy regimens for the treatment of patients with Hodgkin lymphoma (HL) who relapse after or are refractory to primary therapy. All eligible patients with relapsed or refractory HL should be considered for high-dose chemotherapy with autologous stem cell transplantation. This type of therapy has become the standard of care for patients with chemosensitive disease, based on numerous phase II and two phase III clinical trials. The major considerations in the choice of salvage therapy are response rate, toxicity, and effect on subsequent stem cell collection. For patients who do not respond to salvage therapy or who relapse after autologous transplantation, available treatment options include additional salvage regimens, reduced-intensity allogeneic stem cell transplantation, and investigational agents. This review summarizes the results of various salvage chemotherapy regimens, including newer regimens that incorporate gemcitabine, in addition to novel therapies that are currently being studied in patients with relapsed or refractory HL.