Part 4: Advanced-Stage and Relapsed/Refractory Hodgkin Lymphoma

Jasleen Randhawa, MD

Fellow, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Sai Ravi Pingali, MD

Fellow, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Timothy S. Fenske, MD

Associate Professor of Medicine, Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI

Question 4

A 35-year-old man was previously treated with 6 cycles of ABVD for stage IV-B classical Hodgkin lymphoma. He completed therapy 7 months earlier and achieved a complete remission. He now presents with new cervical adenopathy. PET/CT scan shows abnormal FDG uptake in the neck, mediastinum, and retroperitoneal regions, along with several liver lesions concerning for active lymphoma. Excisional biopsy of the cervical adenopathy confirms recurrent classical Hodgkin lymphoma. He is then treated with a regimen of ifosfamide, carboplatin, and etoposide (ICE) for 2 cycles with a follow-up PET/CT scan showing a complete metabolic response. Which subsequent treatment plan would be associated with the best chance for long-term disease-free survival?

  •   Two more cycles of ICE
  •   High-dose chemotherapy with autologous stem cell rescue
  •   Involved-field radiation therapy
  •   MOPP (nitrogen mustard, vincristine, procarbazine, prednisone)
  •   Brentuximab vedotin

Updated 10/01/2012 • jdw | Copyright ©2014 Turner White Communications