Managing Hodgkin lymphoma without chemotherapy: a novel, yet ‘welcomed’, challenge

The dawn of the past century saw the exploitation of radiation therapy in Hodgkin lymphoma (HL) and its ensuing cures in some of the treated patients. Subsequent developments in the study of malignant diseases, and an improved understanding of lymphoma growth, led to the discernment that a tailored approach is warranted in patients with HL. As such, this type of lymphoma is one of the most curable malignancies nowadays, with a 5-year overall survival exceeding 80% for all stages combined [1].

Presently, the main issue in the management of HL, particularly in patients with early-stage and low-risk disease, remains the long-term side effects and possible deaths resulting from the use of chemotherapy and radiation therapy. When all stages of the disease are taken into consideration, the cancer itself accounts for the largest number of deaths, whereas secondary malignancies account for the second most common cause of death. By contrast, data looking into limited-stage disease shows that secondary cancers are the main cause of deaths in these patients [2].

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