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Hodgkin lymphoma (HL) patients are usually being allocated to early favorable, early unfavorable, and advanced-stage risk groups. Intensity of treatment thus depends on clinical stage and the presence of clinically defined risk factors. With current standard treatment approaches including chemo- and/or radiotherapy, cure rates range from 60 to 90%. With this excellent prognosis, many patients would be sufficiently treated with less aggressive strategies than the current standard. To avoid overtreatment in low-risk patients and maintain the appropriate treatment intensity for high-risk patients at the same time, response-adapted treatment stratification based on interim positron emission tomography (PET) is under investigation. Treatment stratification on the basis of the mutation status of specific genes or upon guidance by minimal residual disease (MRD) as currently evaluated in other malignancies would be even more desirable but is difficult in HL. The reason for this is that the malignant Hodgkin and Reed−Sternberg (H-RS) cells usually account for less than 1% of cells in the lymphoma tumor tissue at initial diagnosis. However, several signaling pathways dysregulated in H-RS cells were identified recently and an increasing number of drugs specifically targeting these pathways are becoming available. Small molecules, monoclonal antibodies, and immunotoxins are among the most promising candidates for a more selective treatment and might become part of future personalized treatment approaches in HL patients. This chapter gives an overview on current and possible future targeted approaches in HL. [ABSTRACT FROM AUTHOR]

Hodgkin lymphoma (HL) is a rare human cancer with about 8,500 new cases in the United States [1]. It is estimated that 1,290 patients will die of this malignancy in 2009, making HL one of the best curable human cancers. Despite the success of initial therapy, the treatment of patients with relapsed and refractory disease, especially those who relapse after autologous stem cell transplantation, remains challenging with an estimated median survival of less than 3 years [2]. Furthermore, because the median age of the patients is in the mid-30s, the impact of early mortality on the number of years lost from productive life is remarkable. Drug development in this area will, therefore, address a significant unmet medical need [3]. Over the past decade, several potential therapeutic targets in HL have been identified, and are currently under preclinical and clinical investigation [3, 4]. This chapter will focus on promising new monoclonal antibodies and small molecules that are currently in clinical trials for the treatment of patients with relapsed HL. [ABSTRACT FROM AUTHOR]

Lymphocyte-predominant Hodgkin lymphoma (LPHL) was first described in 1944 by Jackson and Parker as nodular paragranuloma [1]. Other synonyms used were lymphocytic predominant Hodgkin disease, lymphocytic and histiocytic (L&H) predominant Hodgkindisease, nodular lymphocyte-predominant Hodgkin disease, and nodular LPHL [2–5]. This term has become the one that is currently being used. LPHL represents 5% of all HL cases and is a rare disease with an estimated incidence of 1.5 per million [6]. LPHL differs from classical Hodgkin lymphoma in pathological and clinical characteristics. [ABSTRACT FROM AUTHOR]

Patients with CS I/II Hodgkin lymphoma (HL) and unfavorable prognostic factors (higher age, more involved areas, bulky mediastinal involvement, B-symptoms, and/or elevated ESR) are currently treated with a combination of chemotherapy and involved field RT (IF-RT). The standard combined modality treatment regimen consists of four cycles of ABVD followed by IF-RT with 30–36 Gy. Progression-free and overall survival rates of 85–95% are being reached with this approach. Concern on long-term toxicity as well as attempts to reduce the risk of treatment failure are the major challenges in this group of patients. It remains to be seen whether IF-RT can be reduced to involved node RT. The same holds true for the decrease in the RT dose to 20 Gy. Whether RT can be completely omitted for certain subgroups of patients resulting in reduction of long-term toxicity is still under debate. Another unsolved relevant question is whether subsets of patients should start with BEACOPP escalated chemotherapy instead of ABVD in an attempt to improve the primary tumor control. Meticulous designs of prospectively randomized trials in large cooperative efforts are needed more than ever to solve these issues. [ABSTRACT FROM AUTHOR]