From ASH Meeting on Hematologic Malignancies: How would you treat a patient with nodular sclerosing Hodgkin lymphoma?

During their presentations, MHM speakers will be asking the audience how they would respond to patient cases. Audience members will vote live at the meeting via an audience response system, but we want to know what you would do. Email your response to [email protected].

Patient Case:

Mary, a 23-year-old woman presents with a left supraclavicular mass, which has been slowly growing over 3 months. Over the past 6 months, pruritus has been steadily worsening, but she has no other symptoms. A biopsy is performed and pathology comes back with nodular sclerosing Hodgkin lymphoma. She has a normal CBC and renal and liver function. A PET/CT scan is performed and shows left lower neck, mediastinal, left hilar lymphadenopathy, largest 4 cm.

Here’s how MHM attendees would treat this patient:

a. ABVD x 6 (13%)

b. ABVD x 2 + IFRT (30%)

c. ABVD x 3 => PET scan (52%)

d. PET negative => stop Tx; PET positive => IFRT (0%)

e. Mantle radiotherapy (5%)

f. AVD + brentuximab vedotin x 4 (0%)

ASH Clinical News readers felt differently:

a. ABVD x 6 (32%)

b. ABVD x 2 + IFRT (18%)

c. ABVD x 3 => PET scan (32%)

d. PET negative => stop Tx; PET positive => IFRT (14%)

e. Mantle radiotherapy (0%)

f. AVD + brentuximab vedotin x 4 (4%)