Hodgkin Lymphoma, Version 2.2012 Featured Updates to the NCCN Guidelines

Authors:
  • RARanjana H. Advani
    Ranjana H. Advani
  • WAWeiyun Z. Ai
    Weiyun Z. Ai
  • RARichard F. Ambinder
    Richard F. Ambinder
  • PAPatricia Aoun
    Patricia Aoun
  • CBCeleste M. Bello
    Celeste M. Bello
  • PBPhilip J. Bierman
    Philip J. Bierman
  • KBKristie A. Blum
    Kristie A. Blum
  • RCRobert Chen
    Robert Chen
  • BDBouthaina Dabaja
    Bouthaina Dabaja
  • YDYsabel Duron
    Ysabel Duron
  • AFAndres Forero
    Andres Forero

Abstract
The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Hodgkin Lymphoma (HL) include the clinical management of classical HL and lymphocyte-predominant HL (LPHL). Major changes have been incorporated into these guidelines since their inception. In the 2012 NCCN Guidelines for HL, PET scans are not recommended for interim restaging of patients with stage I to II favorable disease. After reevaluating the available evidence on the use of interim PET imaging, the panel recommends the use of diagnostic CT scan of involved sites for interim restaging after completion of chemotherapy for this group of patients. Maintenance rituximab for 2 years is included as an option for patients with stage IB to IIB or stage III to IV LPHL treated with rituximab alone in the first-line setting. Brentuximab vedotin is included as an option for patients with progressive disease or relapsed disease after second-line chemotherapy or high-dose therapy with autologous stem cell rescue. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Hodgkin Lymphoma (HL) include the clinical management of classical HL and lymphocyte-predominant HL (LPHL). Major changes have been incorporated into these guidelines since their inception. In the 2012 NCCN Guidelines for HL, PET scans are not recommended for interim restaging of patients with stage I to II favorable disease. After reevaluating the available evidence on the use of interim PET imaging, the panel recommends the use of diagnostic CT scan of involved sites for interim restaging after completion of chemotherapy for this group of patients. Maintenance rituximab for 2 years is included as an option for patients with stage IB to IIB or stage III to IV LPHL treated with rituximab alone in the first-line setting. Brentuximab vedotin is included as an option for patients with progressive disease or relapsed disease after second-line chemotherapy or high-dose therapy with autologous stem cell rescue.