Hodgkin lymphoma (HL) presenting in patients with co-incidental advanced age, pregnancy, or human immunodeficiency virus (HIV) infection is uniquely challenging to manage. In this article we integrate recent evidence and clinical expertise to present recommendations for diagnosis and therapeutic management. Older patients with HL need to be carefully evaluated for comorbidies after which judicious choice of chemotherapy should minimize functional compromise. A pregnant patient with concurrent HL should be staged with minimal use of imaging requiring ionizing radiation and treated in an individualized manner optimally combining the strategies of treatment deferral when appropriate, use of single-agent vinblastine for symptomatic disease and reservation of multi-agent chemotherapy for the small minority of patients with aggressive clinical presentation. Treatment of HL coincident with HIV infection requires a combination of highly active anti-retroviral agents (HAART), standard multi-agent chemotherapy with meticulous attention to drug–drug interactions, and vigorous supportive care to ensure the best chance of cure.
|Original language||English (US)|
|Number of pages||6|
|Journal||Seminars in hematology|
|State||Published - Jul 1 2016|
Bibliographical noteFunding Information:
JMC is the Clinical Director of the British Columbia Cancer Agency Centre for Lymphoid Cancer. The authors gratefully acknowledge funding support from the Terry Fox Research Institute (JMC), Genome Canada (JMC), Genome British Columbia (JMC), the Canadian Institutes for Health Research (JMC) and the British Columbia Cancer Foundation (JMC). VB is receiving support from Minnesota Masonic Charities.
- Hodgkin lymphoma