Research into Hodgkin lymphoma
We don’t know exactly what causes Hodgkin lymphoma. Researchers are looking at tissue and blood samples taken from people with Hodgkin lymphoma. They use the samples to look at DNA and find out about any viruses that the person may have had. They’re especially interested in a virus called Epstein Barr, which can be linked to Hodgkin lymphoma.
Treatment
Researchers are looking at treatment for people with Hodgkin lymphoma.
Chemotherapy
There are trials looking at improving chemotherapy treatment for people with Hodgkin lymphoma.
They are looking into:
- different combinations of chemotherapy
- adapting chemotherapy regimes for young adults that are usually used for children
- reducing chemotherapy side effects
- giving some people less chemotherapy
- how chemotherapy affects quality of life
Targeted therapies
Targeted therapies are drugs that change the way that cells work and help the body control the growth of cancer. Some targeted drugs seek out and destroy cancer cells. Others help the immune system to attack the cancer.
Researchers are using monoclonal antibodies which target proteins called receptors on some Hodgkin lymphoma cells. Sometimes monoclonal antibodies are attached to chemotherapy drugs on radioactive molecules so that they can be delivered straight to the cancer cells. This is called targeted treatment.
People with Hodgkin lymphoma are involved in different trials looking at different types of targeted therapy.
The drugs being studied include:
- pembrolizumab
- brentuximab
- nivolumab
- avelumab
- BI 1206
Stem cell and bone marrow transplant
Mini transplant
Most stem cell transplants for Hodgkin lymphoma are autologous. This means you have your own stem cells collected and you have them back after high dose chemotherapy. But doctors are also looking at using allogeneic stem cell transplants, where the stem cells come from a donor. The donor cells are matched closely to the proteins on your own cells.
For some people this can get rid of their Hodgkin lymphoma. But the donor cells can also attack normal body cells and cause a reaction called graft versus host disease (GvHD).
The mini transplant (or reduced intensity conditioning transplant) gives lower doses of chemotherapy than usual transplants. The chemotherapy doses you have are too low to destroy your own bone marrow. You have just enough chemotherapy to damp down your bone marrow until the transplanted donor cells have settled into it and started to produce blood cells.
Transplant specialists think these transplants might reduce the side effects of treatment, while still treating the lymphoma.
Scans
Doctors are always looking to improve ways of staging Hodgkin lymphoma to help make decisions about treatment. And to know how well treatment has worked.
Doctors are looking at and comparing many different scans and imaging techniques, including PET-CT and PET-MRI. Doctors hope that using these scans might mean some people can safely be given less treatment in the future.
Keeping fertility after treatment
If you have not had children, or would like more in the future, your doctor will try and use drugs that do not cause infertility. But this isn’t always possible. Having high dose chemotherapy and a stem cell transplant will almost certainly mean you will be infertile.
It is possible for men or teenage boys to bank sperm before chemotherapy so they can still have children.
In women, researchers are looking into the possibility of removing some ovarian tissue before chemotherapy and then freezing it. The aim is to be able to re-implant the ovarian tissue after treatment is over. This is still a very new and experimental procedure. It will be some time before we know whether this works well.
Children and young people
Researchers are looking at trying to reduce the chance of children who are treated for Hodgkin lymphoma being infertile when they grow up. Doctors are looking at only giving radiotherapy to young people if they really need it. And giving chemotherapy drugs that are less likely to cause long term fertility problems.
