Changes to This Summary (09/23/2011)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

General Information About Adult Hodgkin Lymphoma

Updated statistics with estimated new cancer cases and deaths for 2011 (cited American Cancer Society as reference 1).

Cellular Classification of Adult Hodgkin Lymphoma

Added text to state that despite a usually favorable prognosis, there is a tendency for histologic transformation to diffuse large B-cell lymphoma in around 10% of patients by 10 years (cited Al-Mansour et al. as reference 7).

Added text to state that for patients with advanced stage nodular lymphocyte-predominant Hodgkin lymphoma (HL), chemotherapy regimens designed for non-HLs may be preferred, based on a retrospective review (cited Canellos et al. as reference 15 and level of evidence: 3iiiDii).

Treatment Option Overview

Revised text to state that at a 20-year follow-up, the risk of second solid tumors is approximately 17%. Also added that even with involved-field doses of 15 Gy to 25 Gy, sarcomas, breast cancers, and thyroid cancers occurred with similar incidence in young patients receiving higher-dose radiation (cited O'Brien et al. as reference 16).

Added text to state that HL patients treated with mediastinal radiation compared with a normal-matched population have been reported to be at increased risk with the use of cardiac procedures (cited Galper et al. as reference 45).

Early Favorable Hodgkin Lymphoma

Added Canellos et al. as reference 7.

Early Unfavorable Hodgkin Lymphoma

Added text about 1,395 patients and the 6.8 year median follow-up in the HDII trial, stating that in the arms of the study with 30 Gy of involved-field radiation therapy (IF-XRT), there was no difference in freedom-from-treatment failure (FFTF) between BEACOPP (bleomycin plus etoposide plus doxorubicin plus cyclophosphamide plus vincristine plus procarbazine plus prednisone) and ABVD (doxorubicin plus bleomycin plus vinblastine plus dacarbazine), but a significant difference in favor of BEACOPP was seen for FFTF when 20 Gy of IF-XRT was used (cited Eich et al. as reference 13 and levels of evidence 1iiA and 1iiD).

Advanced Favorable Hodgkin Lymphoma

Added text to include CEC (cyclophosphamide plus lomustine plus vindesine plus melphalan plus prednisone plus epidoxorubicin plus vincristine plus procarbazine plus vinblastine plus bleomycin) to the drug combinations described.

Revised text to state that Stanford V is an alternative drug combination with mandated radiation consolidation for most patients and survival rates comparable to those with ABVD (cited Hoskin et al. as reference 6 and level of evidence 1iiA).

Added text to state that a prospective randomized trial of 307 patients with advanced-stage disease compared ABVD, BEACOPP, and CEC and that with a median follow-up of 41 months, there was no significant difference in overall survival (cited Federico et al. as reference 8 and level of evidence 1iiDiii). Also added that further follow-up is required to assess rates of secondary malignancies with these regimens.

Advanced Unfavorable Hodgkin Lymphoma

Revised text to state that Stanford V is an alternative drug combination with mandated radiation therapy consolidation for most patients and survival rates comparable to those with ABVD (cited Hoskin et al. as reference 7 and Gobbi et al. as reference 8).

Added text to state that the German Hodgkin Lymphoma Study Group HD15 trial showed that a negative positron–emission tomography scan after BEACOPP induction therapy was highly predictive for a good outcome even with omission of consolidative radiation therapy (cited Kobe et al. as reference 13).

Recurrent Adult Hodgkin Lymphoma

Added Sarina et al. as reference 23 and Kuruvilla et al. as reference 24.