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Treatment Options for Hodgkins Lymphoma

A patient receives immunotherapy treatment for Hodgkins LymphomaThe Lymphoma Program has pioneered targeted therapies, such as Brentuximab vedotin (SGN-35), an antibody-drug conjugate that targets CD30, the defining marker of Hodgkins Lymphoma.

At Stanford we offer a full spectrum of the most up to date and advanced therapies for all stages of Hodgkin's lymphoma, including treatment for relapsed disease. Standard treatment depends on the stage of disease and consists of chemotherapy alone, a combination of chemotherapy and radiation therapy (combined modality therapy), or raditaion therapy alone. Our focus is on using regimens that achieve a high cure rate, preserve fertility, and minimize late effects.

Chemotherapy

Chemotherapy is the basis of treatment for Hodgkin's lymphoma for most patients and uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body. The standard approach to Hodgkin's lymphoma chemotherapy is treatment with more than one anticancer drug.

Drug combinations are used because different medications damage or kill cancer cells in different ways, making them more vulnerable to the treatment. Drugs added together in lower doses also help reduce the likelihood of side effects without reducing the overall amount of effective chemotherapy.  Commonly used regimens are Stanford V (Stanford “Five”) and ABVD. For a highly selected group of high risk patients, escalated BEACOPP is used. With the recent FDA approval of brentuximab vedotin (Adcetris), we have trials evaluating this drug in the front-line setting, as well as other small molecules for relapsed disease.

Radiation therapy

Radiation therapy is often used in the management of Hodgkin’s disease, usually in combination with chemotherapy.  Generally the sequence is to complete the chemotherapy and to follow up with radiation beginning 2-4 weeks later.  Radiation is limited to the areas where disease was present at the time of diagnosis.  The dose used is much lower than that required for common cancers such as prostate cancer or breast cancer.  Small doses are given each day, 5 days per week, for 2 ½-5 weeks.  Mild local side effects may develop in the area being treated, but they generally resolve shortly after treatment is completed.-

Stem Cell Transplant
When a patient’s Hodgkin's lymphoma does not respond to primary treatment or returns, a stem cell transplant is recommended. Stanford has a highly established transplant program performing over 200 procedures every year. We have pioneered the use of less toxic conditioning regimens and clinical trials incorporating novel therapies with bone marrow transplantation.

Hodgkin's lymphoma Clinical Trials
Since Stanford is one of the leading research centers in the United States, we offer clinical trials of new treatments for every stage and type of Hodgkin's lymphoma.

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