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Hodgkin Lymphoma, Version 1.2015

Classical HL Treatment - For Clinicians

| - For Patients

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The NCCN Quick Guide


series and NCCN Guidelines for Patients


are supported by charitable

donations made to the NCCN Foundation


. For more details and the full library of patient and

caregiver resources, visit


What are options for first-time treatment?

Stages III

and IV

Stage III and IV cancers are on both sides of your diaphragm or have

widely spread outside the lymphatic system.


One option is 2 ABVD cycles then either 4 ABVD or BEACOPP

cycles, which are often followed by radiation therapy. A second option

is 12 weeks of Stanford V followed by radiation therapy. If younger

than 60 years with a good cancer outlook, a third option is 6 cycles of

BEACOPP, which may be followed by radiation therapy.


What if first-time treatment doesn’t work?

Cancer that grows during or soon after first-time treatment is called refractory disease.

Chemotherapy or brentuximab vedotin is first used to shrink the cancer. If treatment is or

may be working, you may have a stem cell transplant with or without radiation therapy. If

treatment doesn’t work, you may receive other drug treatments with or without radiation

therapy. Radiation therapy alone is also an option to treat refractory disease following

chemotherapy or brentuximab vedotin.


What are options if the cancer returns?

Cancer that re-appears on tests after a cancer-free period is called a relapse. Treatment

options for stage IA or IIA depend on whether you had radiation therapy before. If not,

chemotherapy or brentuximab vedotin with or without stem cell transplant, radiation therapy,

or both is first used to treat relapse. For some people, radiation therapy alone may be first

used. Treatment for all other relapsed cancers is like treatment for refractory disease.


What care should I receive after treatment?

Follow-up care starts when there are no signs of cancer after treatment. It should consist

of health tests that check for cancer and any problems caused by cancer treatment. It’s

also important to get care that will help to prevent other illnesses.


How do I decide between options?

Ask your doctors many questions. Also, you could get a second opinion, attend support

groups, and compare pros and cons.

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NCCN Guidelines

for Patients


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