Hodgkin Lymphoma Treatment
Our patients with Hodgkin lymphoma (HL) are usually treated with chemotherapy, radiation therapy, or a combination of the two, depending on the extent of the disease.
The goal of chemotherapy is to destroy the abnormal cells and induce (cause) disease remission in a process called induction. Physicians who treat Hodgkin lymphoma can choose from among more than 20 different chemotherapy drugs, most used in multi-drug combinations, depending on the patient’s disease type and other factors. Most HL patients receive their induction therapy in our state-of-the-art chemotherapy clinic on an outpatient basis.
Occasionally, patients may receive progressive induction therapy in a state-of-the art inpatient unit with a team of nurses who have special training and experience in this aspect of patient care. Because chemotherapy can also damage healthy cells, for safety’s sake, you will stay in the unit for approximately one month.
Hodgkin lymphoma cells contain a compound called CD30 on their surfaces. A new drug called brentuximab vedotin (also called SGN-35), approved by the FDA in 2011, seeks out and attaches itself to CD30, carrying with it a chemotherapy drug that destroys the lymphoma cells. This new drug is now part of our routine treatment strategy for patients whose Hodgkin lymphoma has progressed (continued to get worse) after a blood and marrow transplant, or for patients who cannot undergo transplant and whose disease has not responded to at least two rounds of chemotherapy.
Often radiation is given to Hodgkin lymphoma patients in combination with chemotherapy. Depending on the case, radiation may also be given with high-dose chemotherapy as part of blood and marrow transplant or to relieve painful symptoms of the disease.
Some Roswell Park patients receive drugs that boost the immune system — for example, lenalidomide, which has multiple mechanisms-of-action, including its ability to shut down the growth of new blood vessels that feed cancer cells. Lenalidomide is currently being studied in clinical research studies (clinical trials) in various subtypes of lymphoma, including Hodgkin lymphoma.
Blood and Marrow Transplantation
Patients with Hodgkin lymphoma may be eligible for a blood and marrow transplant (BMT). A broad range of patients, from ages 4 to 75, may be considered for BMT at Roswell Park.
Roswell Park is home to the most experienced adult BMT service in Western New York, performing 160-180 transplants every year. Because BMT can be a treatment option for lymphoma patients who have aggressive disease or who have relapsed following other treatment, our physicians work closely with our BMT specialists to evaluate the status of all of our lymphoma patients on an ongoing basis, to determine who might benefit from the procedure. This helps ensure that everything is in place and ready to go if a transplant should be necessary.
Outcomes for patients treated through the Blood and Marrow Transplant Center at RPCI are among the highest in the nation. The 2014 Center for International Blood and Marrow Transplant Research report shows that Roswell Park achieved higher than expected one-year survival ratings for allogeneic blood and marrow transplants.
Roswell Park offers two types of BMT:
- For an autologous transplant, your stem cells are collected in advance, at a time when you have little or no evidence of disease in your blood. Then any residual lymphoma in your body is destroyed with chemotherapy and/or radiation, and afterward, the stem cells that were collected previously are given back to you, in a procedure called a rescue.
- For an allogeneic transplant, your diseased bone marrow is destroyed with chemotherapy and/or radiation, and afterward, you receive stem cells from a healthy donor in a procedure called a rescue. All patients between the ages of 4 and 75 are carefully considered as potential BMT candidates, depending on the unique circumstances of each patient and their disease.