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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.

Treatment path

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

consist of:


is doxorubicin, bleomycin, vinblastine,

and dacarbazine.

Stanford V

is doxorubicin, vinblastine,

mechlorethamine, etoposide,vincristine,

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.

Cancer Res

. 1971 Nov;31(11):1860-1.