Treating Relapsed and Refractory Hodgkin Lymphoma

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The clinical management of patients with relapsed or refractory Hodgkin lymphoma is difficult. In general, the standard of care is salvage chemotherapy followed by autologous stem cell transplant, for patients who are sensitive to chemotherapy. However, if patients are not eligible for transplants the treatment decision becomes more complicated, since a myriad of options exist, Lauren C. Pinter-Brown, MD, points out.

Craig H. Moskowitz, MD, employs ifosfamide, carboplatin, and etoposide (ICE) as a first-line salvage therapy. However, he notes, other regimens are effective and the ultimate goal of treatment should be remission, regardless of the exact regimen administered.

The exact regimen to administer relies on the ultimate treatment goals and needs, Pinter-Brown suggests. In some situations, inpatient regimens, such as ICE, may be inconvenient for patients, requiring the switch to an outpatient treatment, such as gemcitabine, vinorelbine, and liposomal doxorubicin (GVD). To this point, Jonathan W. Friedberg, MD, notes that he prefers GVD as a first-line salvage therapy, since his patients generally travel long distances to receive treatment.

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