Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Eichenauer, Dennis A.; Aleman, Berthe M.P.; André, Marc; Federico, Massimo; Hutchings, Martin; Illidge, Tim; Engert, Andreas; Ladetto, Marco

doi:10.1093/annonc/mdy080

Cited by 320 publications

(353 citation statements)

References 50 publications

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“…Although it is traditionally considered a laboratory inflammation indicator, the process of erythrocyte sedimentation is influenced by other numerous physiological and pathophysiological factors, most significant being anemia, alterations in RBC morphology, and presence of paraproteins, thus limiting its utility in inflammatory conditions . With the introduction of more specific inflammatory biomarkers, its usefulness has decreased and nowadays ESR remains helpful in the diagnosis and monitoring of a limited number of clinical conditions, in particular rheumatoid diseases, orthopedic infections, and Hodgkin's lymphoma …”

Section: Introductionmentioning

confidence: 99%

Analytical validation of the iSED automated analyzer for erythrocyte sedimentation rate

Lapić

Miloš

Tosato

et al. 2019

Int J Lab Hematology

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Introduction iSED is an alternate automated analyzer for erythrocyte sedimentation rate (ESR) based on photometric rheology technology that estimates ESR by measuring rouleaux formation. The aim was to evaluate the analytical performance of the iSED analyzer and compare the results with the Westergren method and another alternate ESR analyzer, TEST1. Methods Validation was performed at two study sites according to the recommendations by the International Council for Standardization in Haematology and included determination of intrarun precision and inter‐run precision, bias, carryover, and method comparison, which was further assessed for samples with normal and low hematocrit, as well as per low, middle, and upper third of the analytical range. Results Intrarun coefficients of variation (CVs) with commercial controls were 4.0% and 1.8%, while inter‐run CVs 7.5% and 0.7%, for the normal and pathological range, respectively. Intrarun CVs obtained with patient samples were 19.9%, 9.9%, 10.3%, and 9.4%, the highest being for the lowest ESR value. Correlation coefficients for the comparison between iSED and Westergren were 0.862 (Site‐1) and 0.916 (Site‐2). While proportional difference with a positive bias was revealed at Site‐1, comparison at Site‐2 showed both constant and proportional difference and a negligible negative bias. Higher correlation was obtained for samples with low than normal hematocrit. Comparison between iSED and TEST1 yielded a correlation coefficient of 0.986, constant and proportional difference, and positive bias. Carryover was 3.2%. Conclusion This study proved the analytical validity of the iSED analyzer, despite minor discrepancies to the Westergren method that can be attributed to methodological differences.

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Section: Introductionmentioning

confidence: 99%

Analytical validation of the iSED automated analyzer for erythrocyte sedimentation rate

Lapić

Miloš

Tosato

et al. 2019

Int J Lab Hematology

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“…Near universal expression of CD20 by malignant lymphocyte‐predominant (LP) cells, a tendency for late relapses and the risk of transformation to aggressive large B‐cell lymphoma are also characteristic features with important implications for treatment and follow‐up (Advani & Hoppe, ; Eichenauer & Engert, ). While treatment strategies have historically been extrapolated from CHL, recognition of the distinct clinicopathological features of NLPHL have led to the development of specific guidelines (Eichenauer et al , ; Hoppe et al , ). In this review we summarize the current concepts of the unique clinical and patho‐biological aspects of NLPHL and discuss emerging modern principles in management.…”

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confidence: 99%

Modern principles in the management of nodular lymphocyte‐predominant Hodgkin lymphoma

2018

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Summary Nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) is a unique rare subtype of Hodgkin lymphoma (HL) which differs clinically, pathologically and biologically from classic HL, warranting a nuanced approach to treatment. CD20 expression by malignant lymphocyte‐predominant cells, a tendency for late relapses, and the risk of transformation to aggressive large B‐cell lymphoma are characteristic features with important implications for treatment and follow‐up. Recognition of histopathological variant patterns is also critical, with important implications for prognosis and treatment. The optimal management for NLPHL is unclear and opinions differ as to whether treatment paradigms should be similar to, or differ from, those for classic HL. Therapy differs for early versus advanced stage disease and for frontline versus relapsed or refractory disease. Potential treatment strategies include radiotherapy, combined modality therapy, chemotherapy, rituximab and watchful waiting. Given the excellent overall survival of NLPHL, treatment choices should be geared towards reducing long‐term toxicity and optimizing survivorship. In this review, we provide an overview of the current literature and discuss modern principles in the management of NLPHL.

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“…The initial staging of HL is performed by positron emission tomography‐computed tomography (PET‐CT) scan (PET), as recommended by the Lugano classification (Cheson et al , ). Interestingly, a bone marrow biopsy (BMB) is no longer required when a PET is performed for initial staging (El‐Galaly et al , ; Eichenauer et al , ). In the study reported by El‐Galaly et al (), 18% of patients had focal skeletal lesions on PET‐CT, but only 6% had positive BMB.…”

Section: Prognostic Factorsmentioning

confidence: 99%

“…The recently published ESMO guidelines (Eichenauer et al , ) recommend that patients with early stage favourable disease should receive either 2 cycles ABVD and 20 Gy involved site (IS) RT or 2 cycles ABVD and an iPET; if iPET‐negative, patients should be treated with 1 cycle ABVD and 20 Gy IS‐RT; iPET‐positive patients should receive 2 cycles BEACOPP esc and 30 Gy IS‐RT. Intermediate/unfavourable stage patients should be treated with 4 cycles ABVD or 2 cycles BEACOPP esc + 2 cycles ABVD and 30 Gy IS‐RT or 2 cycles ABVD and an iPET; if iPET‐negative, treatment should continue with 2 cycles ABVD and 30 Gy IS‐RT; if iPET‐positive patients should receive 2 cycles BEACOPP esc and 30 Gy IS‐RT (Eichenauer et al , ).…”

Section: European Society For Medical Oncology (Esmo) National Comprmentioning

confidence: 99%

Therapeutic recommendations for early stage Hodgkin lymphomas

2018

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Summary Combined modality treatment has been the standard option for the treatment of early stage Hodgkin lymphoma for several decades. Because of the high success rate and the risk of late toxicities, recent clinical trials have focused on reducing the treatment burden. Field and dose of radiotherapy, and number of cycles of chemotherapy have been successfully reduced, particularly for favourable early stage patients. However, the impact of these treatment reductions on the rate of secondary malignancies remains still unclear. Positron emission tomography‐computed tomography (PET‐CT) scanning has emerged as a very important tool for disease staging and end of treatment assessment. Interestingly, a PET performed after 2 cycles of ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) has been correlated with final outcome and was recently evaluated in a randomized clinical trial to evaluate individualized therapy based on PET response after 2 or 3 cycles of ABVD. These trials aimed to identify good prognosis (early PET‐negative) patients who could be spared radiotherapy, but also patients with a bad prognosis (early PET‐positive) who need more intensive treatment. More recently, new drugs, such as brentuximab vedotin and checkpoint inhibitors, have shown efficacy in relapsed/refractory patients and are currently under evaluation in early stage patients.

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Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Cited by 320 publications

References 50 publications

Analytical validation of the iSED automated analyzer for erythrocyte sedimentation rate

Analytical validation of the iSED automated analyzer for erythrocyte sedimentation rate

Modern principles in the management of nodular lymphocyte‐predominant Hodgkin lymphoma

Therapeutic recommendations for early stage Hodgkin lymphomas

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