Authors: Móciková H. 1; Michalka J. 2; Sýkorová A. 3; Lukášová M. 4; Hradská K. 5; Černá N. 6; Baranová J. 6; Marková J. 1; Gahérová Ľ. 1; Maco M. 1; Maule E. 2; Janíková A. 2; Štěpánková P. 3; Kredátusová A. 4; Ďuraš J. 5; Prochazka V. 4; Král Z. 2; Kozák T. 1 Authors‘ workplace: Hematologická klinika 3. LF UK a FN Královské Vinohrady, Praha 1; Interní hematologická a onkologická klinika LF MU a FN Brno 2; IV. interní hematologická klinika LF v Hradci Králové UK a FN Hradec Králové 3; Hematoonkologická klinika LF UP a FN Olomouc 4; Klinika hematoonkologie LF OU a FN Ostrava 5; Institut biostatistiky a analýz, s. r. o, Brno 6 Published in: Klin Onkol 2026; 39(1): 45-55 Category: Original Articles
Background: The aim of this analysis was to assess the efficacy of treatment and its impact on prognosis of patients with Hodgkin’s lymphoma (HL) enrolled in the Czech HL Registry. Patients and methods: Overall 2,241 patients with classical HL (cHL) and 130 patients with nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) treated between 2000 and 2024 were analyzed. Median age at diagnosis was 37 years in cHL and 42 years in NLPHL. Results: The most common chemotherapy regimen in early and intermediate stages was ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) in combination with radiotherapy (RT). Moreover, two cycles of escalated BEACOPP (bleomycin, etoposide doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone) combined with two cycles of ABVD and RT were used in patients aged < 60 years in intermediate stages. The most common therapy in advanced stages was escalated BEACOPP (4–8 cycles) in patients aged < 60 years and ABVD (6–8 cycles) in patients aged ≥ 60 years. Patients with NLPHL were treated with RT alone or with combination of rituximab and chemotherapy or with a combination of RT based on clinical stages. The 10-year progression–free survival (PFS) and overall survival (OS) in patients with cHL aged < 60 years were: in early stages 91.5% and 94.2%, in intermediate stages 91.0% and 96.6% and in advanced stages 83.9% and 92.6%, respectively. The 10-year PFS and OS in cHL ≥ 60 years were: in early stages 67.0% and 74.2%, in intermediate stages 36.4% and 45.7%, in advanced stages 41.6% and 52.0%, respectively. The 10-year PFS and OS in NLPHL patients were 77.5% and 95.8%. Conclusion: Based on the data from the Czech HL Registry, the prognosis of HL patients aged < 60 years is excellent: the 10-year OS is achieved in more than 90% of cases. Median OS of patients aged ≥ 60 years is 10 years. Implementation of checkpoint inhibitors or brentuximab vedotin into the first-line treatment will further improve its efficacy and reduce the toxicity.
Hodgkin lymphoma – ABVD – BEACOPP
1. Cheson BD, Fisher RI, Barrington SF et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014; 32 (27): 3059–3068. doi: 10.1200/JCO.2013.54.8800.
2. Cheson BD, Horning SJ, Coiffier B et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17 (4): 1244. doi: 10.1200/JCO.1999.17.4.1244.
3. Cheson BD, Pfistner B, Juweid ME et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25 (5): 579–586. doi: 10.1200/JCO.2006.09.2403.
4. Engert A, Plütschow A, Eich HT et al. Reduced treatment intensity in patients with early-stage Hodgkin‘s lymphoma. N Engl J Med 2010; 363 (7): 640–652. doi: 10.1056/NEJMoa1000067.
5. Sasse S, Bröckelmann PJ, Goergen H et al. Long-term follow-up of contemporary treatment in early-stage Hodgkin lymphoma: updated analyses of the German Hodgkin study group HD7, HD8, HD10, and HD11 trials. J Clin Oncol 2017; 35 (18): 1999–2007. doi: 10.1200/JCO.2016.70.9410.
6. Behringer K, Goergen H, Hitz F et al. Omission of dacarbazine or bleomycin, or both, from the ABVD regimen in treatment of early-stage favourable Hodgkin‘s lymphoma (GHSG HD13): an open-label, randomised, non--inferiority trial. Lancet 2015; 385 (9976): 1418–1427. doi: 10.1016/S0140-6736 (14) 61469-0.
7. Böll B, Goergen H, Behringer K et al. Bleomycin in older early-stage favorable Hodgkin lymphoma patients: analysis of the German Hodgkin Study Group (GHSG) HD10 and HD13 trials. Blood 2016; 127 (18): 2189–2192. doi: 10.1182/blood-2015-11-681064.
8. Fuchs M, Goergen H, Kobe C et al. Positron emission tomography-guided treatment in early-stage favorable Hodgkin lymphoma: final results of the International, randomized phase III HD16 trial by the German Hodgkin Study Group. J Clin Oncol 2019; 37 (31): 2835–2845. doi: 10.1200/JCO.19.00964.
9. Fuchs M, Jacob AS, Kaul H et al. Follow-up of the GHSG HD16 trial of PET-guided treatment in early-stage favorable Hodgkin lymphoma. Leukemia 2024; 38 (1): 160–167. doi: 10.1038/s41375-023-02064-y.
10. Belada D, Trněný M. Diagnostické a léčebné postupy u nemocných s maligními lymfomy. XV. Vydání. 2025 [online]. Dostupné z: https: //www.lymphoma.cz/_uploads/attachments/KLS_guidelines_2025_31579.pdf.
11. Eich HT, Diehl V, Görgen H et al. Intensified chemotherapy and dose-reduced involved-field radiotherapy in patients with early unfavorable Hodgkin‘s lymphoma: final analysis of the German Hodgkin Study Group HD11 trial. J Clin Oncol 2010; 28 (27): 4199–4206. doi: 10.1200/JCO.2010.29.8018.
12. von Tresckow B, Plütschow A, Fuchs M et al. Dose--intensification in early unfavorable Hodgkin‘s lymphoma: final analysis of the German Hodgkin Study Group HD14 trial. J Clin Oncol 2012; 30 (9): 907–913. doi: 10.1200/JCO.2011.38.5807.
13. Gillessen S, Plütschow A, Fuchs M et al. Intensified treatment of patients with early stage, unfavourable Hodgkin lymphoma: long-term follow-up of a randomised, international phase 3 trial of the German Hodgkin Study Group (GHSG HD14). Lancet Haematol 2021; 8 (4): e278–e288. doi: 10.1016/S2352-3026 (21) 00029-6.
14. Borchmann P, Plütschow A, Kobe C et al. PET-guided omission of radiotherapy in early-stage unfavourable Hodgkin lymphoma (GHSG HD17): a multicentre, open-label, randomised, phase 3 trial. Lancet Oncol 2021; 22 (2): 223–234. doi: 10.1016/S1470-2045 (20) 30601-X.
15. Diehl V, Franklin J, Pfreundschuh M et al. Standard and increased-dose BEACOPP chemotherapy compared with COPP-ABVD for advanced Hodgkin‘s disease. N Engl J Med 2003; 348 (24): 2386–2395. doi: 10.1056/ NEJMoa022473.
16. Borchmann P, Haverkamp H, Diehl V et al. Eight cycles of escalated-dose BEACOPP compared with four cycles of escalated-dose BEACOPP followed by four cycles of baseline-dose BEACOPP with or without radiotherapy in patients with advanced-stage Hodgkin‘s lymphoma: final analysis of the HD12 trial of the German Hodgkin Study Group. J Clin Oncol 2011; 29 (32): 4234–4242. doi: 10.1200/JCO.2010.33.9549.
17. Engert A, Haverkamp H, Kobe C et al. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin‘s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet 2012; 379 (9828): 1791–1799. doi: 10.1016/S0140-6736 (11) 61940-5.
18. Borchmann P, Goergen H, Kobe C et al. PET-guided treatment in patients with advanced-stage Hodgkin‘s lymphoma (HD18): final results of an open-label, international, randomised phase 3 trial by the German Hodgkin Study Group. Lancet 2017; 390 (10114): 2790–2802. doi: 10.1016/S0140-6736 (17) 32134-7.
19. Kreissl S, Goergen H, Buehnen I et al. PET-guided eBEACOPP treatment of advanced-stage Hodgkin lymphoma (HD18): follow-up analysis of an international, open-label, randomised, phase 3 trial. Lancet Haematol 2021; 8 (6): e398–e409. doi: 10.1016/S2352-3026 (21) 00101-0.
20. Borchmann P, Ferdinandus J, Schneider G et al. Assessing the efficacy and tolerability of PET-guided BrECADD versus eBEACOPP in advanced-stage, classical Hodgkin lymphoma (HD21): a randomised, multicentre, parallel, open-label, phase 3 trial. Lancet 2024; 404 (10450): 341–352. doi: 10.1016/S0140-6736 (24) 01315-1.
21. Herrera AF, Leblanc ML, Castellino SM et al. Nivolumab-AVD in advanced stage classic Hodgkin lymphoma. N Engl J Med 2024; 391 (15): 1379–1389. doi: 10.1056/ NEJMoa2405888.
22. Subramanian A, Shengqin S, Flerlage J et al. Distinct cell state ecosystems for nodular lymphocyte-predominant Hodgkin lymphoma. Nat Commun 2025; 16 (1): 8473. doi: 10.1038/s41467-025-63339-9.
23. Salvaris RT, Allanson BM, Collins G et al. Nodular lymphocyte-predominant Hodgkin lymphoma: advances in disease biology, risk stratification, and treatment. Haematologica 2024; 109 (11): 3476–3487. doi: 10.3324/haematol.2024.285903.
24. Nogova L, Reineke T, Eich HT et al. Extended field radiotherapy, combined modality treatment or involved field radiotherapy for patients with stage IA lymphocyte-predominant Hodgkin’s lymphoma: a retrospective analysis from the German Hodgkin Study Group (GHSG). Ann Oncol 2005; 16 (10): 1683–1687. doi: 10.1093/annonc/mdi323.
25. Fanale MA, Cheah CY, Rich A et al. Encouraging activity for R-CHOP in advanced stage nodular lymphocyte-predominant Hodgkin lymphoma. Blood 2017; 130 (4): 472–477. doi: 10.1182/blood-2017-02-766121.
26. Wilson MR, Bagguley T, Smith A et al. Frontline management of nodular lymphocyte predominant Hodgkin lymphoma-a retrospective UK multicentre study. Br J Haematol 2019; 186 (6): e214–e217. doi: 10.1111/bjh.16109.
27. Moskowitz CH, Nademanee A, Masszi T et al. Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin‘s lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2015; 385 (9980): 1853–1862. doi: 10.1016/S0140-6736 (15) 60165-9.
28. Desai SH, Spinner MA, Evens AM et al. Overall survival of patients with cHL who progress after autologous stem cell transplant: results in the novel agent era. Blood Adv 2023; 7 (23): 7295–7303. doi: 10.1182/bloodadvances.2023011205.
29. Michalka J, Král Z, Marková J et al. Konsolidační léčba brentuximab vedotinem u pacientů s relabujícím/refrakterním klasickým Hodgkinovým lymfomem po provedení autologní transplantace hematopoetických kmenových buněk v České republice. Onkologie 2023; 17 (4): 267–272. doi: 10.36290/xon.2023.051.
30. Král Z, Michalka J, Móciková H et al. Treatment of relapsed/refractory Hodgkin lymphoma: real-world data from the Czech Republic and Slovakia. J Cancer 2019; 10 (21): 5041–5048. doi: 10.7150/jca.29308.
31. Ansell SM, Bröckelmann PJ, von Keudell G et al. Nivolumab for relapsed/refractory classical Hodgkin lymphoma: 5-year survival from the pivotal phase 2 Check - -Mate 205 study. Blood Adv 2023; 7 (20): 6266–6274. doi: 10.1182/bloodadvances.2023010334.
32. Kuruvilla J, Ramchandren R, Santoro A et al. Pembrolizumab versus brentuximab vedotin in relapsed or refractory classical Hodgkin lymphoma (KEYNOTE-204): an interim analysis of a multicentre, randomised, open-label, phase 3. Lancet Oncol 2021; 22 (4): 512–524. doi: 10.1016/S1470-2045 (21) 00005-X.
33. Armand P, Zinzani PL, Lee HJ et al. Five-year follow-up of KEYNOTE-087: pembrolizumab monotherapy for relapsed/refractory classical Hodgkin lymphoma. Blood 2023; 142 (10): 878–886. doi: 10.1182/blood.2022019386.
Don‘t have an account? Create new account
Enter the email address that you registered with. We will send you instructions on how to set a new password.
