Vol 2, No 1 (2011)
Review paper
Published online: 2011-03-24

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Optimization and individualization of treatment based on interim PET result in patients with Hodgkin lymphoma

Jan Maciej Zaucha
Hematologia 2011;2(1):15-22.

Abstract

Classification of Hodgkin lymphoma (HL) into 2 types: nodular and classical that is divided in the other 4 subtypes do not adequately reflect the diversity of this disease in terms of biology. This reflects well the imperfect classification of patients into 3 clinical groups with different prognosis and the lack of satisfactory options for treatment individualization. As a consequence, there are different standards of treatment, especially in patients with high risk factors. Treatment with BEACOPPesc program allows achieving long-lasting remission in nearly 90% of patients, but is hampered by significant early and late toxicity. Tolerance of doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) is better, but sustained response is achieved only in 70% of patients. There is now some data suggesting that interim positron emission tomography (PET) combined with computed tomography (CT) in patients with HL predicts response to the standard ABVD treatment. A positive interim PET result indicates a treatment failure and the need for the treatment intensification. Retrospective studies demonstrate the effectiveness of this approach and encourage conducting prospective clinical studies verifying the effectiveness of interim PET to optimize therapy in patients with early and advanced form of HL.
Hematologia 2011; 2, 1: 15–22

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Hematology in Clinical Practice