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Research in Hodgkin lymphoma
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat Hodgkin lymphoma (HL). They are also looking for ways to improve the quality of life of people with HL.
The following is a selection of research showing promise for HL. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year.
Diagnosis and prognosis
A key area of research looks at better ways to diagnose and stage HL. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.
The ratio of lymphocytes to monocytesin the blood may help doctors predict a prognosis for different types of HL for people in different age groups. A study found that using this ratio helped doctors predict both progression-free survival and overall survival for classic HL, especially for nodular sclerosis HL. Another study found that a higher number of lymphocytes than monocytes is linked with better overall survival, especially in people younger than 60 years of age. Further study is needed before doctors can use this ratio as a common tumour marker for predicting prognosis (Hematological Oncology, PMID 25224646; Mayo Clinic Proceedings, PMID 26046410; The Oncologist, PMID 26921291).
ABVD chemotherapy along with modern antiretroviral therapy improves prognosis and survival for people with advanced stage classic HL and HIV infection. ABVD is a combination of doxorubicin (Adriamycin), bleomycin (Blenoxane), vinblastine and dacarbazine. Antiretroviral therapy is used to treat HIV (Cancer, PMID 25251326).
Find out more about research in diagnosis and prognosis.
Researchers are looking for new ways to improve treatment for HL. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer. The following is noteworthy research into treatment for HL.
Chemotherapy with BEACOPP is a highly effective but quite intense treatment for HL. BEACOPP is a combination of bleomycin, etoposide (Vepesid, VP-16), doxorubicin, cyclophosphamide (Procytox), vincristine (Oncovin), procarbazine hydrochloride (Matulane) and prednisone. Researchers compared BEACOPP to ABVD, which is a combination of doxorubicin, bleomycin, vinblastine and dacarbazine. Some studies show that BEACOPP is better at preventing relapse than ABVD, but no studies show that BEACOPP improves overall survival. This is because effective treatments, such as high-dose chemotherapy followed by autologous stem cell transplant, can be used when initial treatment with BEACOPP or ABVD does not effectively treat the HL. Although BEACOPP is more effective than ABVD, it also causes more side effects. When doctors decide which treatments to offer, they need to balance the effectiveness of treatment with the side effects and illness that they may cause. Further study is needed to understand the side effects of BEACOPP (International Journal of Hematology, PMID 27531149).
Improvements in external radiation therapy techniques may help reduce side effects when radiation is used to treat HL in the mediastinum. A study compared 3-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT). Fewer people treated with IMRT had acute side effects than those treated with 3D-CRT. Improvements to radiation techniques for HL appear to make them safer, but longer follow-up is needed to assess the types and severity of late side effects that develop after these techniques are used (British Journal of Radiology, PMID 26744079).
Targeted therapy drugs that help the immune system recognize and attack cancerous Hodgkin cells are used to treat some types of HL. Early studies show that nivolumab (Opdivo) may be effective treatment for classic HL (Journal of Blood Medicine, PMID 28546779).
Autologous stem cell transplant after high-dose chemotherapy may be a safe treatment option for some carefully selected healthy people with HL who are older than 70 years of age. A study concluded that doctors should not use the person’s age to rule out autologous stem cell transplant as a treatment option (ASCO, Abstract e19003).
Allogeneic stem cell transplant may be a treatment option for some people with HL and HIV infection. In the past doctors preferred not to offer an allogeneic transplant because it can lead to a life-threatening infection. But a study of people with HIV infection and a blood cancer or HL found that carefully selected people treated with an allogeneic transplant and intensive anti-HIV therapy did not have a relapse causing death at 100 days after the transplant or infections that caused death at 1 year after the transplant. The study concluded that doctors should consider an allogeneic transplant as a treatment option for this group of people if they meet the eligibility criteria (ASCO, Abstract 7006).
Follow-up after treatment with either CT scan or the combination of PET and CT scans (called PET-CT scan) doesn’t need to be done for early stage classic HL treated with ABVD and radiation therapy because there is a very low risk that early stage HL will relapse (Cancer, PMID 25739719).
Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects. The following is noteworthy research into supportive care for HL.
Gonadotropin-releasing hormone (GnRH) drugs may help preserve fertility in women treated for HL. Researchers looked at using GnRH drugs as adjuvant therapy with different chemotherapy drugs. The GnRH drugs were given to help protect the ovaries so they would work normally after treatment. One year after treatment was finished, 82% of women had normal ovarian function. After 2 years, nearly 91% of women had normal ovarian function (Journal of Assisted Reproduction and Genetics, PMID 25724588; Expert Opinion on Pharmacotherapy, PMID 25826240).
Learn more about cancer research
Researchers continue to try to find out more about HL. Clinical trials are research studies that test new ways to prevent, detect, treat or manage HL. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for HL were first shown to be effective through clinical trials.