Relapsed/refractory Hodgkin lymphoma: what is the best salvage therapy and do we need RIC-alloSCT?

For relapsed-refractory Hodgkin Lymphoma, standard therapy consists of salvage chemotherapy followed by autologous stem cell transplantation. Adverse risk factors at relapse include response duration less than 12 months, advanced stage, extranodal disease, "B" symptoms and anemia. There is no obvious superior salvage regimen although maintaining dose-intensity is important for optimal responses. Assessment of response to salvage using FDG-PET identifies a distinct poor risk group, especially those with extranodal disease. Either a second salvage regimen or a tandem autologous transplant may benefit some patients with residual disease post-salvage. Reduced-intensity allografting may provide durable responses for some patients relapsing post-autologous transplant.