There is evidence that these patients are best treated with an approach involving salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (HDCT/ASCT). This approach may result in cure, with better results in patients with low-risk relapse.
What are the treatment options for relapsed Hodgkin lymphoma (Hodgkin disease)?
Relapse/refractory Hodgkin lymphoma patients are still a clinical concern. Indeed, despite more effective first-line chemotherapy regimens and better stratification of unresponsive patients by clinical factors and use of early PET, roughly one-third of such patients need salvage chemotherapy and consolidation with high-dose chemotherapy.
What is the relapse rate for salvage therapy in Hodgkin's lymphoma?
Salvage therapy in Hodgkin's lymphoma Hodgkin's disease is a rare malignancy that affects approximately 7,500 patients per year in the U.S., leading to an estimated 1,400 deaths. The relapse rate for this disease varies from around 5% for early-stage disease to 35% for patients with advanced disease. Patients who relapse after chemother …
What are the treatment options for relapsed or refractory hepatocellular carcinoma (HL)?
Salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (ASCT) for patients with chemotherapy-sensitive disease is a standard treatment sequence for relapsed or refractory (rel/ref) HL. Patients who achieve complete response prior to ASCT have better survival outcomes.
How many HL patients need salvage chemotherapy after first-line treatment?
Analysing data from several prospective, randomized studies, we can conclude that 2%-30% of HL patients (all stages together) required salvage chemotherapy (CT) because of a relapsed/refractory (R/R) status after first-line treatment.
How do you treat relapsed Hodgkin's lymphoma?
Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant.
How is relapsed lymphoma treated?
Treatment options for lymphoma that's relapsed more than once might include:a different chemotherapy regimen.a stem cell transplant using donor stem cells (an 'allogeneic' stem cell transplant)radiotherapy, if the lymphoma is only affecting one part of your body.More items...
How I treat relapsed/refractory Hodgkin?
Abstract. Relapsed or refractory Hodgkin lymphoma is a challenging problem for clinicians who treat hematologic malignancies. The standard management of these patients should include the use of salvage chemotherapy followed by autologous stem cell transplant (ASCT) in patients who are chemotherapy sensitive.
Is relapsed Hodgkin's lymphoma curable?
Although Hodgkin lymphoma (HL) is largely curable with first-line therapy, approximately one-third of patients will not have a complete response to frontline treatment or will subsequently relapse. Only 50 % of these patients will be effectively salvaged with conventional therapies.
How common is Hodgkin's lymphoma relapse?
Up to 90% of recurrences happen before the five-year mark. The occurrence of relapse after 10 years is rare. After 15 years, developing lymphoma is the same as its risk in the normal population. Even with a recurrence, many people with Hodgkin lymphoma go on to live long lives.
What is ICE chemotherapy for Hodgkin?
ICE chemotherapy refers to a chemotherapy regimen that includes ifosfamide, carboplatin, and etoposide. Doctors often prescribe this treatment for people with Hodgkin lymphoma and non-Hodgkin lymphoma that has come back. Many individuals who undergo ICE chemotherapy also have a stem cell transplant.
What is the difference between relapse and refractory?
Relapsed disease means a cancer has come back. Refractory disease means a cancer has stopped responding to treatment.
Can refractory lymphoma be cured?
The prognosis for these patients is poor, especially for those who have high-risk factors such as secondary IPI score >2 or relapse ≤12 months post-ASCT. Thus, most patients with refractory DLBCL have no curative treatment options.
Can we cure refractory Hodgkin's lymphoma with transplantation?
a Non-relapse mortality, b Relapse, c Progression-free survival, d Overall survival. very advanced HL, refractory to multiple lines of therapy, can still be cured with allogeneic transplantation.
Can you survive Hodgkin's lymphoma twice?
According to the American Cancer Society, survival rates for Hodgkin's lymphoma have improved in recent years, thanks to advances in treatment. The 5-year survival rate is currently about 87 percent . That's a higher rate than many other cancers. However, relapse is still possible.
What is the treatment for Hodgkin lymphoma?
Hodgkin lymphoma patients who fail to achieve complete remission following frontline therapy or who relapse after achieving complete remission are often treated with second-line chemotherapy regimens, followed by a bone marrow or stem cell transplant. A transplant of bone marrow or stem cells is needed to restore healthy bone marrow.
How long does it take for HL to relapse?
For classical HL, most relapses typically occur within the first three years following diagnosis, although some relapses occur much later. For patients who relapse or become refractory, secondary therapies are often successful in providing another remission and may even cure the disease.
What is relapsed lymphoma?
The term “relapsed” refers to disease that reappears or grows again after a period of remission. The term “refractory” is used to describe when the lymphoma does not respond to treatment (meaning that the cancer cells continue to grow) or when the response to treatment does not last very long.
What factors determine the type of treatment for a patient?
The type of treatment prescribed for individual patients depends on several factors, including the timing of the relapse, age and overall health of the patient, scope of disease, and previous therapies received.