NCCN Guidelines for Patients
Hodgkin Lymphoma, Version 1.2015
Treatment guide: Classical Hodgkin lymphoma
Part 4 is a guide to the treatment
options for people with classical
Hodgkin lymphoma. Classical types
include nodular sclerosis, mixed
cellularity, lymphocyte-depleted, and
First-time treatment is listed in Parts 4.1 and 4.2
by cancer stage.* If unknown, ask your treatment
team what the cancer stage is. Parts 4.4 and 4.5
list treatment options for if first-time treatment fails.
Follow-up care is addressed in Part 4.5.
This information is taken from the treatment
guidelines written by NCCN experts of Hodgkin
lymphoma. These treatment guidelines list options for
people with Hodgkin lymphoma in general. Thus, your
doctors may suggest other treatment for you based
on your health and personal wishes.
You will receive rounds of treatment and testing until
the cancer is gone. First-time treatment starts with
chemotherapy. You may receive ABVD, Stanford V, or
escalated BEACOPP. These combination regimens
is doxorubicin, bleomycin, vinblastine,
is doxorubicin, vinblastine,
bleomycin, and prednisone.
Cyclophosphamide may be used instead of
is bleomycin, etoposide,
doxorubicin, cyclophosphamide, vincristine,
procarbazine, and prednisone.
How well the treatment is working will be assessed.
PET/CT completed by one machine or PET with a
diagnostic CT is recommended. However, the value
of using PET in the middle of treatment is unclear in
some cases. Thus, other tests may be used.
Test results are used to decide the next steps of care.
Your doctors may decide that treatment appears
to be working. In this case, your treatment plan will
stay the same. You may start follow-up care or finish
the planned treatment. You may undergo pulmonary
function testing before receiving more than 4 ABVD
cycles. This is to check your lung health.
If the treatment appears to be working poorly, your
treatment plan may change. First, a biopsy is needed
to confirm that cancer is present since imaging
tests can be wrong. If cancer is found, treatment for
refractory cancer is advised.
The same routine of treatment and testing is used
for refractory and relapsed cancers. However, the
treatment for these cancers differs from first-time
treatment. Second-line and other treatments are listed
in Parts 4.3 and 4.4.
* Carbone, Paul PP, et al. Report of the Committee on Hodgkin’s
Disease Staging Classification.
. 1971 Nov;31(11):1860-1.