Management of Hodgkin Lymphoma - Episode 3

Reducing Therapy-Related Toxicity in Hodgkin Lymphoma

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The standard treatment for patients with Hodgkin lymphoma is accompanied by varying degrees of toxicity. As a result, researchers are currently exploring treatments that reduce the risks associated with managing patients. One of these methods, Paul A. Hamlin, MD, explains, was to stop using the MOPP chemotherapy regimen, due to the unacceptably high occurrence of secondary cancers.

As of now, ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine) is the standard chemotherapeutic regimen for treating patients with Hodgkin lymphoma. However, this agent is not without side effects, particularly pulmonary toxicities associated with bleomycin. Outside of chemotherapeutic approaches, radiation oncologists have diligently examined varying doses and administration routes, Hamlin notes.

Given the toxicity concerns, Craig H. Moskowitz, MD, notes, that oncologists are moving away from treatment with bleomycin. The lung toxicity caused by bleomycin can often be fatal, which is not a concern with radiation, Moskowitz points out. Along these lines, Jonathan W. Friedberg, MD, points out that several unsuccessful attempts have been made to omit bleomycin from the regimen. At this point, bleomycin is still an important component of treatment, Friedberg states.

Infertility should also be considered along with toxicities, when seeking to optimize treatment approaches, Lauren C. Pinter-Brown, MD, points out. This is particularly important, she adds, when treating younger patients who have their entire lives ahead of them.