26. Hodgkin lymphoma

Question 1

how is Hodgkin lymphoma histologically classified (WHO)?

Answer 1

classical HL- lymphocyte rich, nodular sclerosis (most common), mixed cellularity, lymphocyte depletion
non-classic HL- nodular lymphocytic predominant (NLP)

Question 2

treatment for stage I-II Hodgkin lymphoma

Answer 2

chemo +radiation
ABVD regimen
*for non-classical –> ABVD + Rituximab (anti-CD20)

Question 3

treatment for stage III-IV Hodgkin lymphoma

Answer 3

ABVD regimen for 6 cycles followed by BEACOPP regimen (Bleomycin, etoposide, adriamycin, cyclophoaphamide, oncovorin, procarbazine, prednisone)

Question 4

treatment for refractory or relapsed Hodgkin lymphoma

Answer 4

• ABVD +/- Brentuximab vedotin (anti-CD30)
• High does chemo+ autologous HSCT
• immune therapy with Nivolumab (PD-1 inhibitor)

Question 5

what are the negative prognostic indicators for HL that form the international prognostic score (IPS)?

Answer 5

albumin, Hb, male, age, stage, WBC, lymphocytes

more than 5 indicators decreases the 5 year survival rate by half