Info
🌱 來自: hodgkin lymphoma (HL)
treatment of hodgkin lymphoma (HL)🚧 施工中
treatment of hodgkin lymphoma (HL)
(NCCN Guidelines v5.2021)
- Stages I–II Hodgkin lymphoma
- Stages III–IV Hodgkin lymphoma
- Refractory_relapsed Hodgkin lymphoma : salvage chemo + auto HSCT ± RT
brentuximab vedotin (BV) 3️⃣ 0️⃣
- Anti-CD30 antibody–drug conjugate therapy in lymphoma
- 且IPS (International Prognostic Score)為4-7 分的CD30+
- 第IV期何傑金氏淋巴瘤(HL)成人病人
- post-ASCT yields some long-term remissions (Blood 2016;128:1562)
PD1/PDL1 blockade (pembrolizumab or nivolumab) (NEJM 2015;372:311, JCO 2017;35:19)
Late treatment effects include ↑ risk for:
- Second cancers: ~4.6× risk for up to 40 y (NEJM 2015;373:2499)
- breast (if RT), ∴ annual screening at age 40 or 8–10 y post RT; leukemia/MDS; NHL
- Cardiac disease (if RT or anthracycline), ? role of echo/stress at 10 y (controversial)
- pulmonary toxicity (if bleomycin); Hypothyroidism (if RT), ∴ annual TSH (if neck RT)
- International Prognostic Score (IPS; JCO 2012;30:3383) risk factors: albumin <4 g/dL, Hb <10.5 g/dL, male gender, age >45 y, stage IV, WBC ≥15 k/µL, lymphocytes <600/µL or <8% of diff. 5-yr PFS 62–88% based on # of risk factors.