Survivors’ perspectives on risks and benefits of Hodgkin lymphoma treatment: results of a survey by the German Hodgkin Study Group

Kreissl, Stefanie; Goergen, Helen; Müller, Horst; Meißner, Julia; Mehnert, Anja; Bürkle, Carolin; Fuchs, Michael; Engert, Andreas; Behringer, Karolin; Borchmann, Peter

doi:10.1080/10428194.2018.1540781

Cited by 22 publications

(13 citation statements)

References 27 publications

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“…However, genotoxic treatment can lead to several complications and might be associated with increased long-term morbidity, including secondary malignancies and cardiovascular disease. A large survey among 1149 Hodgkin lymphoma survivors showed that optimal lymphoma control and primary cure are of utmost importance from the patient's perspective [8]. In advanced stage, these goals can be most effectively achieved through an intensive chemotherapy regimen.…”

Section: Introductionmentioning

confidence: 99%

FDG-PET Imaging for Hodgkin and Diffuse Large B-Cell Lymphoma—An Updated Overview

Voltin

Mettler

Grosse

et al. 2020

Cancers

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Since the mid-1990s, 18F-fluorodeoxglucose (FDG)-positron emission tomography (PET) in combination with computed tomography has come to play a prominent role in the management of malignant lymphomas. One of the first PET applications in oncology was the detection of lymphoma manifestations at staging, where it has shown high sensitivity. Nowadays, this imaging modality is also used during treatment to evaluate the individual chemosensitivity and adapt further therapy accordingly. If the end-of-treatment PET is negative, irradiation in advanced-stage Hodgkin lymphoma patients can be safely omitted after highly effective chemotherapy. Thus far, lymphoma response assessment has mainly been performed using visual criteria, such as the Deauville five-point scale, which became the international standard in 2014. However, novel measures such as metabolic tumor volume or total lesion glycolysis have recently been recognized by several working groups and may further increase the diagnostic and prognostic value of FDG-PET in the future.

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Section: Introductionmentioning

confidence: 99%

FDG-PET Imaging for Hodgkin and Diffuse Large B-Cell Lymphoma—An Updated Overview

Voltin

Mettler

Grosse

et al. 2020

Cancers

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“…Additionally, physical, psychological and socio-economic sequelae during follow-up are more frequent among relapsed survivors, as they require further, even more toxic therapies. 35 Therefore, the study end-point, PFS, reflects the patients´perspective on the most important treatment goal. Accordingly, the current German Hodgkin Study Group (GHSG) standard of care for advanced-stage HL consists of 4-6 cycles of escalated BEACOPP (eBEACOPP; bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine and prednisone) depending on the early response of the tumour (PET2).…”

Section: How Would You Treat This Patient?mentioning

confidence: 99%

“…prioritisation of PFS, not OS, as the most important goal does require prospective validation of a balanced population of patients commencing either ABVD or escalated BEACOPP. 35 Any analysis of patient preferences will always be biased by that of their treating clinician, the gatekeeper to most but not all information in this digital era. Patient preferences may undergo a shift during survivorship follow-up, and also in an environment of rapid therapeutic advances, particularly in salvage therapies.…”

Section: Pet-adapted Approachesmentioning

confidence: 99%

“…Interestingly, most patients are more worried about the risk of relapse and second neoplasia than the risk of death. Additionally, physical, psychological and socio‐economic sequelae during follow‐up are more frequent among relapsed survivors, as they require further, even more toxic therapies 35 . Therefore, the study end‐point, PFS, reflects the patients´ perspective on the most important treatment goal.…”

Section: The Perspective From Germany (S Kreissl Pj Bröckelmann P Bmentioning

confidence: 99%

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How I treat advanced Hodgkin lymphoma — a global view

et al. 2020

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How can you proceed with the diagnostic process? The constellation of fatigue, fevers, night sweats and anaemia associated with mediastinal lymphadenopathy in a younger patient is concerning for a potential lymphoid malignancy. We would assess for weight loss >10% in the last six months, drenching night sweats, high fevers and pruritus. A thorough physical exam should evaluate for palpable lymphadenopathy, evidence of hepatosplenomegaly, and for extra-nodal involvement. If a palpable node is identified, this may be considered for excisional lymph node wider perspectives

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“…Despite overall excellent outcomes, there is no consensus on treatment with regards to conventional chemotherapy, the role of radiotherapy and the incorporation of novel agents across age groups, or for individual patients. Adult HL patients indicate that primary cure is of utmost importance (Kreissl et al , ). Helping clinicians and patients assess individualized treatment options and subsequent screening remains a challenge in the absence of data on the long‐term effects of current treatment strategies.…”

Section: Future Directions For Primary and Secondary Preventions To Cmentioning

confidence: 99%

Closing the survivorship gap in children and adolescents with Hodgkin lymphoma

2019

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Summary The treatment of Hodgkin lymphoma (HL) is one of early success. However, disease‐free survival (DFS) does not reflect latent organ injury and its impact on health status and well‐being beyond 5 years. In fact, we are at a crossroads, in terms of needing individualized approaches to maintain DFS, while minimizing late effects and preserving health‐related quality of life (HRQoL). Premature morbidity and mortality translate to a high societal cost associated with the potential number of productive life years ahead in this population who are young at diagnosis. The discordance between short‐term lymphoma‐free survival and long‐term health and HRQoL creates a “survivorship gap” which can be characterized for individuals and for subgroups of patients. The current review delineates contributors to compromised outcomes and health status in child and adolescent (paediatric) HL and frames the survivorship gap in terms of primary and secondary prevention. Primary prevention aims to titrate therapy. Secondary prevention entails strategies to intervene against late effects. Bridging the survivorship gap will be attained with enhanced knowledge of and attention to biology of the tumour and microenvironment, host genetic factors, HRQoL and sub‐populations with disparate outcomes.

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Survivors’ perspectives on risks and benefits of Hodgkin lymphoma treatment: results of a survey by the German Hodgkin Study Group

Cited by 22 publications

References 27 publications

FDG-PET Imaging for Hodgkin and Diffuse Large B-Cell Lymphoma—An Updated Overview

FDG-PET Imaging for Hodgkin and Diffuse Large B-Cell Lymphoma—An Updated Overview

How I treat advanced Hodgkin lymphoma — a global view

Closing the survivorship gap in children and adolescents with Hodgkin lymphoma

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