Vol 2, No 1 (2011)
Review paper
Published online: 2011-03-24
Optimization and individualization of treatment based on interim PET result in patients with Hodgkin lymphoma
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: 1522
Hematologia 2011; 2, 1: 1522
Keywords: Hodgkin lymphomainterim PET