Guidelines for the first line management of classical Hodgkin lymphoma
Guideline for the first-line management of Classical Hodgkin Lymphoma — A British Society for Haematology guideline
An overview of the epidemiology, pathology and clinical presentation of Hodgkin lymphoma was presented in the previous version of this guideline.1 This updated guideline focuses on the clinical management of adult patients with a diagnosis of classical Hodgkin lymphoma (HL).
Blood evaluation should include full blood count, erythrocyte sedimentation rate (ESR), renal function, liver function, bone profile and testing for HIV and hepatitis B/C.
Patients should be staged with a positron emission tomography (PET) scan, which can accurately detect bone-marrow involvement with HL rendering bone-marrow biopsy unnecessary in most cases.2-4 Diffuse bone-marrow uptake on PET is relatively common and generally reflects a reactive process in HL. A PET and computed tomography scan (CT) with contrast can be helpful for subsequent radiotherapy planning.5
Patients with early-stage disease should be categorised as having favourable or unfavourable characteristics. Patients with advanced-stage disease should have their International Prognostic Score (IPS) determined.6