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Treatment of relapsed or primary refractory Hodgkin lymphoma
Relapsed Hodgkin lymphoma (HL) means that the cancer has come back after treatment. Primary refractory HL means that the cancer is resistant to the initial treatment.
Both relapsed and primary refractory disease require further treatment. Treatment depends on where the HL recurs and on the treatment that was given originally.
The following are treatment options for relapsed or primary refractoryHL. The types of treatments given are based on the unique needs of the person with cancer.
Chemotherapy may be offered for relapsed or primary refractory HL. The same combination of chemotherapy may be given if good response and length of response were achieved originally with the regimen.
Chemotherapy combinations may include:
- doxorubicin (Adriamycin)
- bleomycin (Blenoxane)
- vinblastine (Velbe)
- dacarbazine (DTIC)
- Stanford V
- mechlorethamine (nitrogen mustard, Mustargen)
- vincristine (Oncovin)
- etoposide (Vepesid)
- prednisone (Deltasone)
- cyclophosphamide (Cytoxan, Procytox)
- procarbazine hydrochloride (Matulane)
A different combination of drugs, such as GDP, may be given:
- gemcitabine (Gemzar)
- dexamethasone (Decadron, Dexasone)
- cisplatin (Platinol AQ)
High-dose chemotherapy may be given in preparation for a stem cell transplant, with combinations such as:
- carmustine (BiCNU, BCNU)
- cytarabine (Cytosar)
- melphalan (Alkeran)
- People who have not responded to at least 2 combination chemotherapy regimens or who have relapsed after an autologous stem cell transplant may be given brentuximab vedotin (Adcetris). Health Canada recently approved this drug. Speak to you oncologist about your eligibility for the drug.
External beam radiation therapy may be offered for relapsed or primary refractory HL if the original treatment was chemotherapy only and the HL remains or returns in only a single area. Radiation therapy may be given alone or with more chemotherapy. Radiation therapy may also be used along with chemotherapy in preparation for a stem cell transplant.
Stem cell transplant
A stem cell transplant may be offered for HL that relapses within a few months of original treatment or for refractory disease.
People with HL may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.
Establishing a national caregivers strategy
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.