Resources-Stratified Guidelines for Classical Hodgkin Lymphoma

Hodgkin lymphoma is a haematological malignancy predominantly affecting young adults. Hodgkin lymphoma is a highly curable disease by current treatment standards. Latest treatment guidelines for Hodgkin lymphoma however imply access to diagnostic and treatment modalities that may not be available in settings with restricted healthcare resources. Considerable discrepancies in Hodgkin lymphoma patient survival exist, with poorer outcomes reported in resources-constrained settings. Resources-stratified guidelines for diagnosis, staging and treatment of Hodgkin lymphoma were derived in an effort to optimize patient outcome provided a given setting of available resources. These guidelines were derived based on the framework of the Breast Health Global Initiative stratifying resource levels in basic, core, advanced and maximal categories.

[1]  Z. Dai,et al.  Global, regional, and national burden of Hodgkin lymphoma from 1990 to 2017: estimates from the 2017 Global Burden of Disease study , 2019, Journal of Hematology & Oncology.

[2]  R. Bouabdallah,et al.  PET-adapted treatment for newly diagnosed advanced Hodgkin lymphoma (AHL2011): a randomised, multicentre, non-inferiority, phase 3 study. , 2019, The Lancet. Oncology.

[3]  M. Federico,et al.  Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. , 2018 .

[4]  N. Kalakonda,et al.  Determinants of ovarian function after response-adapted therapy in patients with advanced Hodgkin's lymphoma (RATHL): a secondary analysis of a randomised phase 3 trial , 2018, The Lancet. Oncology.

[5]  A. Jemal,et al.  Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries , 2018, CA: a cancer journal for clinicians.

[6]  J. Friedberg,et al.  CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. , 2018, Blood.

[7]  R. Advani,et al.  NCCN Guidelines Insights: Hodgkin Lymphoma, Version 1.2018 , 2018 .

[8]  C. D. de Souza,et al.  Lower socioeconomic status is independently associated with shorter survival in Hodgkin Lymphoma patients—An analysis from the Brazilian Hodgkin Lymphoma Registry , 2018, International journal of cancer.

[9]  B. Simões,et al.  Treatment outcomes for Hodgkin lymphoma: First report from the Brazilian Prospective Registry , 2018, Hematological oncology.

[10]  R. Greil,et al.  PET-guided treatment in patients with advanced-stage Hodgkin's lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group , 2017, The Lancet.

[11]  J. Connors,et al.  Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin's Lymphoma , 2017, The New England journal of medicine.

[12]  K. Savage,et al.  Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin's Lymphoma. , 2018, New England Journal of Medicine.

[13]  D. Gómez-Almaguer,et al.  High frequency of primary refractory disease and low progression-free survival rate of Hodgkin's lymphoma: a decade of experience in a Latin American center , 2017, Revista brasileira de hematologia e hemoterapia.

[14]  M. Shipp,et al.  Phase II Study of the Efficacy and Safety of Pembrolizumab for Relapsed/Refractory Classic Hodgkin Lymphoma. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[15]  J. Raemaekers,et al.  Early Positron Emission Tomography Response-Adapted Treatment in Stage I and II Hodgkin Lymphoma: Final Results of the Randomized EORTC/LYSA/FIL H10 Trial. , 2017, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  K. Savage,et al.  Checkmate 205 Update with Minimum 12-Month Follow up: A Phase 2 Study of Nivolumab in Patients with Relapsed/Refractory Classical Hodgkin Lymphoma , 2016 .

[17]  Wilbroad Edward Muhogora,et al.  Defining the diagnostic divide: an analysis of registered radiological equipment resources in a low-income African country , 2016, The Pan African medical journal.

[18]  B. Coiffier,et al.  Eight Cycles of ABVD Versus Four Cycles of BEACOPPescalated Plus Four Cycles of BEACOPPbaseline in Stage III to IV, International Prognostic Score ≥ 3, High-Risk Hodgkin Lymphoma: First Results of the Phase III EORTC 20012 Intergroup Trial. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  R. Gascoyne,et al.  US Intergroup Trial of Response-Adapted Therapy for Stage III to IV Hodgkin Lymphoma Using Early Interim Fluorodeoxyglucose-Positron Emission Tomography Imaging: Southwest Oncology Group S0816. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Clement Adebamowo,et al.  Global Health Equity: Cancer Care Outcome Disparities in High-, Middle-, and Low-Income Countries. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[21]  D. Gierga,et al.  Establishing and Delivering Quality Radiation Therapy in Resource-Constrained Settings: The Story of Botswana. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[22]  F. d'Amore,et al.  Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin's Lymphoma. , 2016, The New England journal of medicine.

[23]  R. Greil,et al.  Bleomycin in older early-stage favorable Hodgkin lymphoma patients: analysis of the German Hodgkin Study Group (GHSG) HD10 and HD13 trials. , 2016, Blood.

[24]  R. Digumarti,et al.  Clinical profile and outcome of adult Hodgkin lymphoma: Experience from a tertiary care institution , 2015, Indian Journal of Medical and Paediatric Oncology.

[25]  A. Nademanee,et al.  Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin's lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial , 2015, The Lancet.

[26]  J. Radford,et al.  Results of a trial of PET-directed therapy for early-stage Hodgkin's lymphoma. , 2015, The New England journal of medicine.

[27]  R. Greil,et al.  Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin's lymphoma (GHSG HD13): an open-label, randomised, non-inferiority trial , 2015, The Lancet.

[28]  Bruce D Cheson,et al.  Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[29]  O. Casasnovas,et al.  ABVD (8 cycles) versus BEACOPP (4 escalated cycles ≥ 4 baseline): final results in stage III-IV low-risk Hodgkin lymphoma (IPS 0-2) of the LYSA H34 randomized trial. , 2014, Annals of oncology : official journal of the European Society for Medical Oncology.

[30]  M. Federico,et al.  Epidemiological Overview of Hodgkin Lymphoma across the Mediterranean Basin , 2014, Mediterranean journal of hematology and infectious diseases.

[31]  V. Diehl,et al.  Effect of initial treatment strategy on survival of patients with advanced-stage Hodgkin's lymphoma: a systematic review and network meta-analysis. , 2013, The Lancet. Oncology.

[32]  V. Diehl,et al.  Treatment-related mortality in patients with advanced-stage hodgkin lymphoma: an analysis of the german hodgkin study group. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[33]  E. Negri,et al.  Hodgkin's lymphoma mortality in the Americas, 1997–2008: Achievements and persistent inadequacies , 2013, International journal of cancer.

[34]  A. Zelenetz,et al.  Phase II study of bendamustine in relapsed and refractory Hodgkin lymphoma. , 2013, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[35]  Scott E Smith,et al.  Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin's lymphoma. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[36]  B. Coiffier,et al.  ABVD (8 cycles) versus BEACOPP (4 escalated cycles => 4 baseline) in stage III-IV high-risk Hodgkin lymphoma (HL): First results of EORTC 20012 Intergroup randomized phase III clinical trial. , 2012 .

[37]  H. Amthauer,et al.  Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin's lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial , 2012, The Lancet.

[38]  Bingshu E. Chen,et al.  ABVD alone versus radiation-based therapy in limited-stage Hodgkin's lymphoma. , 2012, The New England journal of medicine.

[39]  R. Küppers,et al.  Hodgkin lymphoma. , 2012, The Journal of clinical investigation.

[40]  C. Poirot,et al.  Management of fertility in patients treated for Hodgkin’s lymphoma , 2011, Haematologica.

[41]  A. Rossi,et al.  ABVD versus BEACOPP for Hodgkin's lymphoma when high-dose salvage is planned. , 2011, The New England journal of medicine.

[42]  R. Greil,et al.  Reduced treatment intensity in patients with early-stage Hodgkin's lymphoma. , 2010, The New England journal of medicine.

[43]  J. Armitage Early-stage Hodgkin's lymphoma. , 2010, The New England journal of medicine.

[44]  M. Sydes,et al.  Consolidation radiotherapy in patients with advanced Hodgkin's lymphoma: survival data from the UKLG LY09 randomized controlled trial (ISRCTN97144519). , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[45]  L. Specht,et al.  Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin’s lymphoma: a systematic review , 2010, Haematologica.

[46]  A. Pettitt,et al.  Randomized comparison of the stanford V regimen and ABVD in the treatment of advanced Hodgkin's Lymphoma: United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[47]  V. Diehl,et al.  Escalated-dose BEACOPP in the treatment of patients with advanced-stage Hodgkin's lymphoma: 10 years of follow-up of the GHSG HD9 study. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[48]  F. Angrilli,et al.  ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin's lymphoma: results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[49]  J. Kuruvilla Standard therapy of advanced Hodgkin lymphoma. , 2009, Hematology. American Society of Hematology. Education Program.

[50]  N. Schmitz,et al.  Reduced-intensity conditioning compared with conventional allogeneic stem-cell transplantation in relapsed or refractory Hodgkin's lymphoma: an analysis from the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation. , 2008, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[51]  G. Laport Allogeneic hematopoietic cell transplantation for Hodgkin lymphoma: a concise review , 2008, Leukemia & lymphoma.

[52]  F. d'Amore,et al.  Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: a report from a joint Italian-Danish study. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[53]  H. Eich,et al.  Two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine plus extended-field radiotherapy is superior to radiotherapy alone in early favorable Hodgkin's lymphoma: final results of the GHSG HD7 trial. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[54]  G. Mead,et al.  ABVD for Hodgkin's lymphoma: full-dose chemotherapy without dose reductions or growth factors. , 2006, Annals of oncology : official journal of the European Society for Medical Oncology.

[55]  R. Carlson,et al.  Breast Cancer in Limited‐Resource Countries: An Overview of the Breast Health Global Initiative 2005 Guidelines , 2006, The breast journal.

[56]  T. Habermann,et al.  Bleomycin pulmonary toxicity has a negative impact on the outcome of patients with Hodgkin's lymphoma. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[57]  H. Eich,et al.  Salvage radiotherapy in patients with relapsed and refractory Hodgkin's lymphoma: a retrospective analysis from the German Hodgkin Lymphoma Study Group. , 2005, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[58]  A. Zelenetz,et al.  Results of a prospective randomized clinical trial of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) followed by radiation therapy (RT) versus ABVD alone for stages I, II, and IIIA nonbulky Hodgkin disease. , 2004, Blood.

[59]  K. Naresh,et al.  Consolidation radiation after complete remission in Hodgkin's disease following six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy: is there a need? , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[60]  J. Raemaekers,et al.  Involved-field radiotherapy for advanced Hodgkin's lymphoma. , 2003, The New England journal of medicine.

[61]  D. Dearnaley,et al.  Predicting the risk of bleomycin lung toxicity in patients with germ-cell tumours. , 2003, Annals of oncology : official journal of the European Society for Medical Oncology.

[62]  Dirk Hasenclever,et al.  Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: a randomised trial , 2002, The Lancet.

[63]  S. Sleijfer Bleomycin-induced pneumonitis. , 2001, Chest.

[64]  V. Diehl,et al.  Gemcitabine in the treatment of refractory Hodgkin's disease: results of a multicenter phase II study. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[65]  F. Berger,et al.  Comparison of chemotherapy to radiotherapy as consolidation of complete or good partial response after six cycles of chemotherapy for patients with advanced Hodgkin's disease: results of the groupe d'études des lymphomes de l'Adulte H89 trial. , 2000, Blood.

[66]  A. Zelenetz,et al.  Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin's lymphoma. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[67]  J. Armitage,et al.  Autotransplants for Hodgkin's disease in patients never achieving remission: a report from the Autologous Blood and Marrow Transplant Registry. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[68]  V. Diehl,et al.  Meta-analysis of chemotherapy versus combined modality treatment trials in Hodgkin's disease. International Database on Hodgkin's Disease Overview Study Group. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[69]  W. Wilson,et al.  Vinblastine for recurrent Hodgkin's disease following autologous bone marrow transplant. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[70]  P. Brousset,et al.  Epstein‐Barr virus‐associated Hodgkin's disease: Epidemiologic characteristics in international data , 1997, International journal of cancer.

[71]  G. Bonadonna,et al.  Outcome of patients with Hodgkin's disease failing after primary MOPP-ABVD. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[72]  D. Leung,et al.  Effect of ABVD chemotherapy with and without mantle or mediastinal irradiation on pulmonary function and symptoms in early-stage Hodgkin's disease. , 1996, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[73]  C. Macmillan,et al.  The effectiveness of radiotherapy for localized relapse in patients with Hodgkin's disease (IIB-IVB) who obtained a complete response with chemotherapy alone as initial treatment. , 1994, Clinical oncology (Royal College of Radiologists (Great Britain)).

[74]  D. Winfield,et al.  Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial , 1993, The Lancet.

[75]  K. Propert,et al.  Chemotherapy of advanced Hodgkin's disease with MOPP, ABVD, or MOPP alternating with ABVD. , 1992, The New England journal of medicine.

[76]  G. Bonadonna,et al.  Combination chemotherapy of Hodgkin's disease with adriamycin, bleomycin, vinblastine, and imidazole carboxamide versus MOPP , 1975, Cancer.