Montanari Francesca, Diefenbach Catherine
Department of Medicine, New York University School of Medicine, NYU Cancer Institute, 240 East 38th Street, 19th Floor, New York, NY, 10016, USA.
Curr Hematol Malig Rep. 2014 Sep;9(3):284-93. doi: 10.1007/s11899-014-0220-7.
Although Hodgkin lymphoma (HL) is largely curable with first-line therapy, approximately one-third of patients will not have a complete response to frontline treatment or will subsequently relapse. Only 50% of these patients will be effectively salvaged with conventional therapies. The prognosis is particularly poor for those patients with chemotherapy refractory disease, who are unable to obtain even transient disease control, and for patients who relapse following high dose chemotherapy and autologous stem cell transplant. In this review, we summarize the most recent updates on the management of patients with relapsed HL, the role of novel therapies such as brentuximab vedotin, and an overview of promising new agents currently under investigation. We also discuss the role of consolidation strategies such as high-dose chemotherapy and autologous stem cell transplant, and reduced-intensity allogeneic hematopoietic stem cell transplant, and the need for new strategies in the elderly patient population.
尽管霍奇金淋巴瘤(HL)一线治疗大多可治愈,但约三分之一的患者对一线治疗不会产生完全缓解或随后会复发。这些患者中只有50%能通过传统疗法得到有效挽救。对于那些化疗难治性疾病患者,即无法获得哪怕短暂疾病控制的患者,以及高剂量化疗和自体干细胞移植后复发的患者,预后尤其差。在本综述中,我们总结了复发HL患者管理的最新进展、新型疗法如本妥昔单抗的作用,以及目前正在研究的有前景的新药物概述。我们还讨论了巩固策略如高剂量化疗和自体干细胞移植、减低强度的异基因造血干细胞移植的作用,以及老年患者群体对新策略的需求。