霍奇金淋巴瘤:2025 年诊断、风险分级和管理的最新进展。

IF 10.1 1区 医学 Q1 HEMATOLOGY
Stephen M Ansell
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引用次数: 0

摘要

疾病概述霍奇金淋巴瘤(HL)是一种不常见的B细胞淋巴恶性肿瘤,每年新增患者8570例,约占美国所有淋巴瘤的10%。诊断:HL由两种不同的疾病实体组成:典型HL和结节性淋巴细胞占优势的HL(也称为结节性淋巴细胞占优势的B细胞淋巴瘤)。结节性硬化、混合细胞性、淋巴细胞耗竭和淋巴细胞丰富型 HL 是典型 HL 的亚组:准确评估 HL 患者的疾病分期对于选择适当的治疗方法至关重要。通过正电子发射断层扫描(PET)确定复发风险低或高的患者以及对治疗的反应,从而采用预后模型来优化治疗:HL患者的初始治疗基于疾病的组织学、解剖学分期以及是否存在预后不良的特征。早期患者通常采用联合模式治疗策略,先进行简短疗程的联合化疗,然后进行介入场放疗,而晚期患者则接受较长疗程的化疗,通常不进行放疗。不过,包括布仑妥昔单抗维多汀和抗PD-1抗体在内的新型药物目前已成为一线治疗的标准药物:大剂量化疗(HDCT)后进行自体干细胞移植(ASCT)是大多数初次治疗后复发患者的标准治疗方法。对于高剂量化疗(HDCT)和自体干细胞移植失败的患者,应考虑使用布仑妥昔单抗(brentuximab vedotin)、PD-1阻断剂、非溶瘤性异基因移植或参与临床试验。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Hodgkin lymphoma: 2025 update on diagnosis, risk-stratification, and management.

Disease overview: Hodgkin lymphoma (HL) is an uncommon B-cell lymphoid malignancy affecting 8570 new patients annually and representing ~10% of all lymphomas in the United States.

Diagnosis: HL is composed of two distinct disease entities: classical HL and nodular lymphocyte predominant HL (also called nodular lymphocyte predominant B-cell lymphoma). Nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte-rich HL are subgroups of classical HL.

Risk stratification: An accurate assessment of the stage of disease in patients with HL is critical for the selection of the appropriate therapy. Prognostic models that identify patients at low or high risk for recurrence, as well as the response to therapy as determined by positron emission tomography (PET) scan, are used to optimize therapy.

Risk-adapted therapy: Initial therapy for HL patients is based on the histology of the disease, the anatomical stage and the presence of poor prognostic features. Patients with early-stage disease are typically treated with combined modality strategies utilizing abbreviated courses of combination chemotherapy followed by involved-field radiation therapy, whereas those with advanced stage disease receive a longer course of chemotherapy often without radiation therapy. However, newer agents including brentuximab vedotin and anti-PD-1 antibodies are now standardly incorporated into frontline therapy.

Management of relapsed/refractory disease: High-dose chemotherapy (HDCT) followed by an autologous stem cell transplant (ASCT) is the standard of care for most patients who relapse following initial therapy. For patients who fail HDCT with ASCT, brentuximab vedotin, PD-1 blockade, non-myeloablative allogeneic transplant or participation in a clinical trial should be considered.

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来源期刊
CiteScore
15.70
自引率
3.90%
发文量
363
审稿时长
3-6 weeks
期刊介绍: The American Journal of Hematology offers extensive coverage of experimental and clinical aspects of blood diseases in humans and animal models. The journal publishes original contributions in both non-malignant and malignant hematological diseases, encompassing clinical and basic studies in areas such as hemostasis, thrombosis, immunology, blood banking, and stem cell biology. Clinical translational reports highlighting innovative therapeutic approaches for the diagnosis and treatment of hematological diseases are actively encouraged.The American Journal of Hematology features regular original laboratory and clinical research articles, brief research reports, critical reviews, images in hematology, as well as letters and correspondence.
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