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08:53
Flow-sorting and Exome Sequencing of the Reed-Sternberg Cells of Classical Hodgkin Lymphoma
Published on: June 10, 2017
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Therapeutic recommendations for early stage Hodgkin lymphomas
Julien Depaus1, Anne Delcourt2, Marc André1
1Department of Haematology, Université catholique de Louvain, CHU UCL Namur, Yvoir, Belgium.
British Journal of Haematology
|November 29, 2018
Summary
Reducing treatment for early Hodgkin lymphoma (HL) lowers toxicity but the effect on secondary cancers is unclear. Positron emission tomography-computed tomography (PET-CT) aids individualized therapy, guiding treatment intensity based on early response.
Area of Science:
- Oncology
- Radiotherapy
- Pharmacology
Background:
- Combined modality treatment is standard for early Hodgkin lymphoma (HL).
- Recent trials aim to reduce treatment burden (radiotherapy fields/doses, chemotherapy cycles) due to high success rates and late toxicity risks.
- The impact of treatment reduction on secondary malignancy rates is still unclear.
Purpose of the Study:
- To evaluate the impact of reduced treatment strategies on secondary malignancy rates in early-stage Hodgkin lymphoma.
- To assess the role of Positron Emission Tomography-Computed Tomography (PET-CT) in guiding individualized therapy based on early treatment response.
- To explore the potential of novel agents like brentuximab vedotin and checkpoint inhibitors in early-stage HL.
Main Methods:
- Review of clinical trials focusing on reduced radiotherapy and chemotherapy in early-stage Hodgkin lymphoma.
- Analysis of Positron Emission Tomography-Computed Tomography (PET-CT) utility for staging and end-of-treatment assessment.
- Evaluation of randomized clinical trials employing PET-CT response to guide individualized therapy (e.g., after 2-3 cycles of ABVD).
Main Results:
- Treatment reductions in radiotherapy and chemotherapy have been successfully implemented for favorable early-stage patients.
- Early Positron Emission Tomography-Computed Tomography (PET-CT) response after ABVD chemotherapy correlates with final outcome.
- PET-CT guided trials aim to spare radiotherapy for PET-negative patients and intensify treatment for PET-positive patients.
Conclusions:
- Further research is needed to clarify the long-term impact of treatment de-escalation on secondary malignancy rates in Hodgkin lymphoma.
- Positron Emission Tomography-Computed Tomography (PET-CT) is a valuable tool for tailoring therapy in early-stage Hodgkin lymphoma.
- Novel therapeutic agents are under investigation for potential application in early-stage Hodgkin lymphoma treatment paradigms.
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