The Fellow on Call: The Heme/Onc Podcast Episode 061: “Paging Heme/Onc: Updates from ASCO 2023” - Classical Hodgkin’s Lymphoma and SWOG 1826
Jun 14, 2023
Dive into the latest in treatments for classical Hodgkin's lymphoma, exploring standard regimens and innovative immunotherapies. The hosts dissect findings from the SWOG 1826 trial, highlighting impressive one-year progression-free survival rates. They unravel the mystery of p-values and what it means when trial results say 'the median was not reached.' This engaging discussion combines medical insights with practical implications, making complex topics accessible and fascinating.
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Pathology Defines Classical Hodgkin Lymphoma
- Classical Hodgkin lymphoma is defined by Reed-Sternberg cells within a dominant inflammatory infiltrate and confirmed with immunohistochemistry.
- Subtypes exist (nodular sclerosis, mixed cellularity, lymphocyte-rich, lymphocyte-depleted) but have limited modern prognostic utility.
Use PET-CT For Accurate Staging
- Stage Hodgkin lymphoma with a PET-CT and classify early versus advanced by diaphragm and extranodal involvement.
- Treat mediastinal bulky disease (>10 cm) as advanced and consider radiation more commonly in pediatrics.
BV-AVD Replaced ABVD In The US
- The US standard for advanced classical Hodgkin lymphoma shifted from ABVD to BV-AVD after the ECHELON-1 trial showed improved outcomes.
- Brentuximab vedotin (BV) is a CD30 antibody-drug conjugate that increased survival in that setting.