What happens if classical Hodgkin lymphoma relapses?

Recurrence or relapse refers to cancer that has come back after a period of remission. Relapses are fairly common with classical Hodgkin lymphoma (cHL), a type of cancer that begins in the white blood cells and lymph nodes.

Here are some key facts about cHL recurrence and relapse:

• The majority of relapses occur within two years of initial treatment.
• Relapses may occur in as many as 15 percent of people who have early-stage disease.
• Relapses may occur in 15 to 30 percent of cases of more advanced disease.
• Approximately 10 to 15 percent of people with Hodgkin’s lymphoma will have refractory disease that either does not respond to initial treatment or progresses after an initial response to treatment.

As a person living with cHL, one of the best things you can do for your health is to continue to work with your healthcare team after the conclusion of your initial treatment. Follow-up care helps your healthcare providers monitor your recovery from cancer and cancer treatment. It also helps monitor for signs that the cancer has returned with exams such as X-rays, PET scans, and CT scans. Appointments may occur every few months for several years.

If your cancer does return, there are multiple ways that it can be treated. Your healthcare team will help you find the best treatment.

Treating a recurrence

Treatment for a recurrence will be different than initial treatment. The therapies used will depend on a number of different factors, including the timing of your relapse, your age, your overall health status, the extent of disease, and previous therapies used.

The exact therapies used will vary from person to person, but it may include some combination of the following:

• Salvage chemotherapy. Salvage chemotherapy is chemo that is given when your cancer has not responded to other treatments. The regimen of chemotherapy drugs used to treat a recurrence will likely be different than those used in the initial treatment. There are many types of chemotherapy drugs that can be used to treat a relapse. The choice will be based around the drugs used during initial treatment and how the cancer responded to those drugs.
• Stem cell transplant (SCT). A stem cell transplant is used in conjunction with high-dose chemotherapy. High-dose chemotherapy is used with the goal of destroying all the cancer cells in the body. Because this will also destroy healthy stem cells, afterward a person will need an infusion of healthy stem cells. These healthy stems cells may be collected from a patient beforehand, or they may come from a donor.
• Targeted therapy. Targeted therapies attach to specific proteins found on the surface of cancer cells. Different targeted therapies fight cancer in different ways. Some block cancers from using proteins to fuel growth. Others deliver anti-cancer medications to cancer cells with precision.
• Immunotherapy. Immunotherapy drugs work by helping the body’s immune system recognize and attack cancer cells.

Remember, treating cHL is a different experience for everyone. There is no best treatment, only the treatment that is best for a particular person at a particular time. Your healthcare team is your best source of information about your diagnosis and treatment options.