19 Nov 2018

What are the effects of different doses and treatments for limited stage classical Hodgkin’s lymphoma?

This study investigated the effects of increasing the initial dose of chemotherapy in patients with classical Hodgkin’s lymphoma (cHL). The main finding was that it is necessary to assess each treatment plan based on the patient’s individual disease.

Chemotherapy plus stem cell transplant (SCT; meaning the transfer of stem cells) and radiation are common treatments for cHLEvent free survival (EFS – didn’t show a specific cancer symptom over a specific period of time), positron-emission tomography (PET – used to diagnose and monitor cancer) scanning and red blood cell sedimentation (blood test for inflammation) are commonly monitored in trials for new therapies/regimes for cHL Different doses and combinations of therapies have different effects in cHL. . It is necessary to investigate the effects of different treatment strategies for cHL.

Two hundred and seventy-eight patients with cHL were studied.  Patients who had received the minimum chemotherapy alone and that had reached remission (no signs of active cancer) were included. EFS and red blood cell sedimentation rate were monitored and PET scanning was carried out.

After 4 years, 49% of patients had received the minimum chemotherapy without radiation. Remission was achieved by 88.8% of patients without receiving high dose chemotherapy plus SCT or high dose radiation. Almost 100% of patients survived. Nearly 76% of patients with nodular sclerosis (a common type of cHL) had event free survival. A slow red blood cell sedimentation rate was linked to greater EFS. Negative PET scan results after 1 cycle of chemotherapy was linked with event free survival.

The study conlcuded that lower doses of chemotherapy were effective in patients who had negative PET scan results and slow red blood cell sedimentation. Higher doses of chemotherapy should be considered for patients with nodular sclerosis plus high ESR or positive PET scan results

Only patients up to the age of 21 were included in this study. Therefore the results may not be representative of patients over 21.