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63

NCCN Guidelines for Patients

®

Hodgkin Lymphoma, Version 1.2015

Treatments for Hodgkin lymphomas don’t always

work the first time. Cancer may also re-appear after

a cancer-free time period. In both cases, a biopsy is

needed to confirm that cancer is present. If it is, the

type of cancer will also be assessed.

If no cancer is found, ongoing follow-up care is

advised. Read Part 5.4 for more information.

Likewise, if cancer is found but not causing

symptoms, follow-up care is advised. Some cancers

do not grow fast and will not need treatment.

Sometimes Hodgkin lymphoma transforms into a fast-

growing non-Hodgkin’s lymphoma. There are

NCCN

Guidelines for Patients

®

for specific types of non-

Hodgkin lymphoma. If available, read the one that

pertains to the new type of cancer you have.

Chart 5.3

maps a treatment path for refractory

or relapsed cancer that is causing symptoms.

Treatment begins with rituximab. Chemotherapy,

radiation therapy, or both may be added. Approved

chemotherapy regimens include:

C-MOPP

(cyclophosphamide, vincristine, procarbazine,

prednisone),

DHAP

(dexamethasone, cisplatin, high-dose

cytarabine),

ESHAP

(etoposide, methylprednisolone, high-dose

cytarabine and cisplatin),

GCD

(gemcitabine, carboplatin, dexamethasone),

GVD

(gemcitabine, vinorelbine, liposomal

doxorubicin),

ICE

(ifosfamide, carboplatin, etoposide),

GEV

(ifosfamide, gemcitabine, vinorelbine),

Mini-BEAM

(carmustine, cytarabine, etoposide,

melphalan), and

MINE

(etoposide, ifosfamide, mesna, mitoxantrone).

If treatment shrinks the cancer, follow-up care can be

started when cancer symptoms stop. Read Part 5.4

for more information. If the cancer is the same or a

larger size, a biopsy is needed.

5

Treatment guide: Nodular lymphocyte-

predominant Hodgkin lymphoma

Treatment for refractory or relapsed cancer