ANDREAS(ENGERT((COLOGNE)(
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FIRST(LINE(TREATMENT(–(INTERMEDIATE(/(ADVANCED(STAGES(
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Hodgkin!lymphoma!(HL)!is!divided!into!classical!Hodgkin!lymphoma!and!nodular!lymphocyte!
predominant! Hodgkin! lymphoma.! The! most! frequent! classical! HL! is! the! nodular! sclerosis!
subtype! (60>80%! of! all! cases)! followed! by! mixed! cellularity! (25>30%),! lymphocyte! rich!
classical!(5%)!and!lymphocyte!depleted!Hodgkin!lymphoma!(about!1%).!Nodular!lymphocyte!
predominant! Hodgkin! lymphoma! represents! about! 5>10%! of! the! disease.! The! disease! is!
divided! into! early! favorable,! early! unfavorable! and! advanced! stage! disease.! About! 30%!
represent!early!favorable,!30%!represent!early!unfavorable!and!40%!advanced!stage!disease.!
!
Hodgkin! lymphoma! had! been! an! uncurable! malignancy! until! the! advent! of!
polychemotherapy.! A! major! breakthrough! was! the! ABVD! regimen! leading! to! cure! in! more!
than! 60%! of! patients.! The! more! aggressive! BEACOPP! regimen! then! further! improved!
outcomes! with! more! than! 80%! of! patients! cured! long>term.! In! the! early! unfavorable! risk!
group,! 4>6! cycles! of! MOPP>ABVD! or! similar! regimen! were! used! followed! by! radiotherapy.!
The! GHSG! HD11! trial! then! demonstrated! that! 4! cycles! of! ABVD! followed! by! 30! Gy!
radiotherapy! gave! promising! tumor! control.! In! the! GHSG! follow>up! trial,! HD14,! 4! cycles! of!
ABVD! +! 30! Gy! IFRT! were! then! compared! with! a! new! regimen! consisting! of! 2! cycles! of!
BEACOPP!escalated!followed!by!2!cycles!of!ABVD!and!radiation.!The!10>year!follow>up!of!this!
trial!demonstrated!a!significantly!better!10>year!PFS!for!the!2+2!combination.!Here,!the!10>
year!PFS!was!91.2%!for!the!2+2!regimen!and!85.6%!for!the!4x!ABVD!treatment.!The!latest!
GHSG!trial!for!early!unfavorable!HL!was!the!HD17!trial.!In!this!trial,!the!standard!treatment!
of!2+2!was!compared!with!a!PET>stratified!treatment.!This!resulted!in!a!significant!reduction!
of!radiotherapy!in!PET>negative!patients.!!
!
In! the! advanced! stage! HL! patients,! the! GHSG! HD9! trial! demonstrated! that! BEACOPP!
escalated!gave!significantly!better!outcomes!as!compared!to!a!baseline!variant!or!a!COPP>
ABVD!variant.!The!GHSG!HD15!trial!then!demonstrated!that!6!cycles!of!BEACOPP!escalated!
were! clearly! better! than! 8! cycles! (p>value! 0.009;! 5>year! PFS! 4.9%).! The! follow>up! trial! for!
advanced!stage!patients,!HD18,!then!demonstrated!that!4!cycles!of!BEACOPP!escalated!were!
sufficient!for!PET>negative!patients.!Our!British!colleagues!demonstrated!that!bleomycin!has!
no! impact! for! Hodgkin! patients! in! advanced! stages! and! thus! should! be! deleted! from! this!
treatment.!More!recently,!a!new!combination!consisting!of!brentuximab!vedotin!plus!AVD!
resulted! in! better! outcomes! as! compared! to! ABVD! alone.! However,! the! results! are! clearly!
inferior!as!compared!to!BEACOPP!escalated.!!
!
New!perspectives!in!patients!with!Hodgkin!lymphoma!particularly!include!the!PD1!inhibition!
in! classical! Hodgkin! lymphoma! demonstrating! that! checkpoint! inhibitors! are! extremely!
effective! in! HL! patients.! More! recently,! our! group! developed! a! new! regimen! for! early!
unfavorable! Hodgkin! lymphoma.! Here,! 4! double>cycles! of! AVD! were! combined! with!
nivolumab! (a! total! of! 8! applications)! demonstrating! that! this! combination! is! extremely!
potent!at!least!in!early!unfavorable!Hodgkin!lymphoma.!
To!summarize!the!outcome!of!Hodgkin!lymphoma!patients!in!2020,!we!demonstrated!that!
Hodgkin! lymphoma! is! a! highly! curable! disease! particularly! in! first>line.! In! early! favorable!
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES