What are NCCN recommendations for treatment of early-stage unfavorable Hodgkin lymphoma (Hodgkin disease)?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The NCCN supports the following treatments for stage I-II unfavorable (non-bulky) CHL [4] :

  • ABVD regimen for two cycles and additional ABVD cycles or ABVD with involved-site radiation therapy (ISRT), as warranted or

  • Stanford V regimen for three cycles (12 weeks) (the regimen includes ISRT) or

  • Escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) regimen for two cycles with ISRT

NCCN recommendations for treatment of early-stage unfavorable (bulky) disease are as follows:

  • ABVD for four cycles (category 1 recommendation) follow by ISRT or

  • Stanford V regimen for three cycles (12 weeks) or

  • Escalated BEACOPP regimen for two cycles plus ABVD for two cycles plus ISRT

The ESMO guidelines recommend four cycles of ABVD with IFRT. In younger patients (≤60 years) a more intensive treatment can be considered, consisting of two cycles of escalated BEACOPP followed by two cycles of ABVD with IF


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