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Modern treatment of Hodgkin lymphoma.

机译：霍奇金淋巴瘤的现代治疗。

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PURPOSE OF REVIEW: The present review summarizes the current therapies and controversies in the management of newly diagnosed and relapsed classical and lymphocyte predominant Hodgkin lymphoma and briefly describes novel agents in development for Hodgkin lymphoma. RECENT FINDINGS: Early restaging fluoro-2-deoxy-D-glucose-positron emission tomography scans appear to provide important prognostic information, particularly in patients with advanced stage Hodgkin lymphoma. A persistently positive scan after two cycles of chemotherapy appears to predict a very dismal outcome, whereas a negative interim scan predicts a very favorable outcome. This finding provides an opportunity to study the effect of tailoring therapy early in the course of disease, perhaps shortening therapy and avoiding radiotherapy in early stage patients with a negative interim scan and escalating therapy in those with positive scans. Recent retrospective studies show it is safe to administer the standard doxorubicin, bleomycin, vinblastine, dacarbazine chemotherapy regimen, prescribed for nearly all patients with Hodgkin lymphoma, at full dose, on schedule without growth factors, minimizing the risk of bleomycin lung toxicity and perhaps improving outcome. Several new drugs are showing promise for refractory Hodgkin lymphoma, including the immunotoxin SGN-35 and the histone deacetylase inhibitor MGCD0103. Rituximab is being studied for the treatment of both classical and lymphocyte predominant Hodgkin lymphoma. SUMMARY: Current trials employing risk-adapted therapy on the basis of interim fluoro-2-deoxy-D-glucose-positron emission tomography scans have the potential of improving outcomes for all patients with Hodgkin lymphoma, either by improving cure rates, minimizing toxicity, or both.
机译：审查的目的：本综述总结了在新诊断和复发的经典和淋巴细胞为主的霍奇金淋巴瘤的治疗中的当前疗法和争议，并简要介绍了霍奇金淋巴瘤发展中的新型药物。最新发现：早期再分期氟-2-脱氧-D-葡萄糖-正电子发射断层扫描似乎可以提供重要的预后信息，尤其是对于晚期霍奇金淋巴瘤患者。经过两个化疗周期的持续阳性扫描似乎预示着非常令人沮丧的结果，而中期扫描阴性则预示了非常有利的结果。该发现为研究在疾病过程早期进行定制治疗的效果提供了机会，在中期扫描阴性的早期患者中可能缩短治疗并避免放疗，而在阳性扫描中的患者则逐步升级治疗。最近的回顾性研究表明，对几乎所有霍奇金淋巴瘤患者开具标准的阿霉素，博莱霉素，长春碱，达卡巴嗪化学疗法方案是安全的，几乎所有剂量的霍奇金淋巴瘤患者均应按计划服用，且无生长因子，可将博来霉素肺毒性的风险降至最低，并可能改善结果。几种新药显示出对难治性霍奇金淋巴瘤的前景，包括免疫毒素SGN-35和组蛋白脱乙酰基酶抑制剂MGCD0103。正在研究利妥昔单抗用于治疗经典型和以淋巴细胞为主的霍奇金淋巴瘤。摘要：目前在临时氟-2-脱氧-D-葡萄糖-正电子发射断层扫描基础上采用适应风险的疗法的试验，有可能通过提高治愈率，将毒性降至最低，改善所有霍奇金淋巴瘤患者的预后，或两者。

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