Universität zu Köln

Broeckelmann, Paul J., Eichenauer, Dennis A., Jakob, Tina, Follmann, Markus ORCID: 0000-0003-3790-5578, Engert, Andreas and Skoetz, Nicole (2018). Hodgkin Lymphoma in Adults. Dtsch. Arztebl. Int., 115 (31-32). S. 535 - 546. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Hodgkin lymphoma is the most common neoplasm in young adults, with an incidence of 2 to 3 cases per 100 000 persons per year. Risk-adapted chemotherapy and radiotherapy usually lead to cure. Finding ways to lessen the treatment-associated morbidity and mortality is a major goal of current research. Methods: For the creation of an updated guideline (DKH grant number 111778), a systematic literature search was carried out in medical databases (MEDLINE, CENTRAL) and guideline databases (GIN) (search dates: January 2012 to June 2017). Results: Results from 10 meta-analyses, 89 randomized and controlled trials, and 81 prospective or retrospective trials were evaluated. The use of positron emission tomography (PET) is strongly recommended in the initial diagnostic evaluation, as well as for the guidance of treatment in advanced stages. In early stages, two cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and involved-site radiotherapy (IS-RT) at a dose of 20 Gy are recommended. For the treatment of intermediate stages, two cycles of escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) + two cycles of ABVD and 30 Gy IS-RT are recommended. In advanced stages, two cycles of escalated BEACOPP are administered, and then PET is performed for the guidance of further treatment: two further cycles of escalated BEACOPP are recommended if the PET is negative and four further cycles if it is positive, followed by radiotherapy of PET-positive residual tumor tissue. The five-year survival of patients with Hodgkin lymphoma is 95%. In case of disease recurrence, high-dose chemotherapy followed by autologous stem-cell transplantation is performed, and targeted drugs including brentuximab vedotin, nivolumab, and pembrolizuab are used. Conclusion: The highly favorable long-term prognosis of HL necessitates careful consideration of the intensity of treatment as well as thorough follow-up to enable the detection of late sequelae, such as second tumors or organ damage.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Broeckelmann, Paul J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichenauer, Dennis A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Jakob, Tina UNSPECIFIED UNSPECIFIED UNSPECIFIED Follmann, Markus UNSPECIFIED orcid.org/0000-0003-3790-5578 UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Skoetz, Nicole UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-176657
DOI:	10.3238/arztebl.2018.0535
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	115
Number:	31-32
Page Range:	S. 535 - 546
Date:	2018
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STEM-CELL TRANSPLANTATION; CANCER-RELATED FATIGUE; HIGH-DOSE CHEMOTHERAPY; NON-INFERIORITY TRIAL; STUDY-GROUP GHSG; OPEN-LABEL; BRENTUXIMAB VEDOTIN; MARROW TRANSPLANTATION; RANDOMIZED-TRIAL; ELDERLY-PATIENTS Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17665