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Hodgkin Lymphoma



Therapy For High Risk Patients


10-20% of patients with advanced stage Hodgkin disease relapse after initial treatment.

High Risk Hodgkin Lymphoma:

Advanced stage disease  - Stage IIIB and IV


Therapy same as for Intermediate Risk - but all patients are all given involved field RT (21 Gy in 150 cGy fractions).

Chemotherapy - MOPP and ABVD derivatives.

COPP used often instead of MOPP as cyclophosphamide is less myelosuppressive and leukemogenic than mechlorethamine.


C = Cyclophosphamide

O = Vincristine (also used to be called Oncovin)

P = Prednisone

P = Procarbazine

Etoposide is sometimes added to improve treatment response and reduce cumulative doses of alkylating agents.


Dose Intensification

  • Used with multiple agents for a shorter duration.
  • MOPP/ABV hybrid regimen is an example.
  • Shorter duration of therapy
  • Lower cumulative doses of chemotherapy
  • Chemotherapy given at weekly intervals for 3 - 5 months  - myelosuppressive drugs alternating with non-myelosuppressive.  Consolidative RT given to sites of bulky disease.
  • Low incidence of fever and neutropenia so G-CSF is not generally used, also some evidence that the use of growth factors with ABDV may increase the  risk of bleomycin induced lung  toxicity.


Eric Rosen had a second stem cell transplant for Stage IV Hodgkin lymphoma. He created “cNOTE”    - a platform to express his synesthetic experience during that time.






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