When to use stem cell transplantation for classical Hodgkin lymphoma

Area of Science:

• Hematology
• Oncology

Background:

• Hodgkin lymphoma (HL) is a rare cancer with a bimodal incidence, affecting young adults and older individuals.
• Conventional treatments like chemotherapy and radiotherapy cure most HL patients.
• Novel therapies, including brentuximab vedotin and checkpoint inhibitors (CPIs), have transformed HL management.

Purpose of the Study:

• To review the evolving role of stem cell transplantation (SCT) in Hodgkin lymphoma.
• To highlight recent data supporting allogeneic hematopoietic cell transplantation (HCT) in specific patient populations.

Main Methods:

• Literature review focusing on recent advancements in HL treatment.
• Analysis of data regarding the utilization of novel therapies and SCT.
• Evaluation of allogeneic HCT outcomes in CPI-refractory/intolerant HL patients.

Main Results:

• Novel therapies have led to reduced use of both autologous and allogeneic HCT in HL.
• Checkpoint inhibitors (nivolumab, pembrolizumab) are increasingly used.
• Allogeneic HCT shows promise as a curative strategy for refractory/intolerant cases.

Conclusions:

• The treatment landscape for Hodgkin lymphoma has significantly shifted with the advent of novel agents.
• While HCT utilization has decreased, allogeneic HCT remains a critical therapeutic option for select patients with advanced or refractory HL.