Hodgkin's Lymphoma

Regimen Options

Last Updated: 02/07/2025 See Details

NOTE: FOR RITUXIMAB, THE USE OF A BIOSIMILAR OR THE REFERENCE PRODUCT IS ON PATHWAY

	Evolent Pathways	Febrile Neutropenic Risk	Emetogenic Risk	References
Classical Hodgkin Lymphoma (CHL)
Primary or Initial Therapy	ABVD (doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Engert A, et al. J Clin Oncl. 2007;25(23):3495-502. Straus DJ, et al. Blood. 2004;104(12):3483-9.
	nivolumab + AVD (doxorubicin, vinblastine sulfate, and dacarbazine)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.1.2025. Herrera AF, et al. N Engl J Med 2024;391:1379-1389
Relapsed/Refractory	ABVD (doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Engert A, et al. J Clin Oncl. 2007;25(23):3495-502. Straus DJ, et al. Blood. 2004;104(12):3483-9. von Tresckow B, et al. J Clin Oncol. 2012;30(8):907-13.
	ICE (ifosfamide, carboplatin and etoposide)	High	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Moskowitz CH, et al. Bone Marrow Transplant. 1999;23(6):561-7. Moskowitz CH, et al. Blood. 2001;97(3):616-23.
	GCD (gemcitabine, carboplatin and dexamethasone)	Low	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Gopal AK, et al. Leuk Lymphoma. 2010;51(8):1523-29.
	DHAP (dexamethasone, cytarabine and cisplatin)	High	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Josting A, et al. Ann Oncol. 2002;13(10):1628-35. Abali H, et al. Cancer Invest. 2008;26(4):401-6.
	GVD (gemcitabine, vinorelbine and doxil)	Low	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Bartlett N, et al. Ann Oncol. 2007;18(6):1071-9.
	MINI-BEAM (carmustine, etoposide, cytarabine and melphalan)	High	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Colwill R, et al. J Clin Oncol. 1995;13(2):396-402. Martin A, et al. Br J Haematol. 2001;113(1):161-71.
	MINE (mesna, ifosfamide, novantrone and etoposide)	High	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Rodriguez MA, et al. J Clin Oncol. 1995;13(7):1734-41.
	pembrolizumab	Low	Low	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Kuruvilla J et al. https://doi.org/10.1016/S1470-2045(21)00005-X
	Best Supportive Care or Clinical Trial	Not Applicable	Not applicable	Best Supportive Care or Clinical Trial
Consolidation/Maintenance therapy after autologous hematopoietic stem-cell transplantation (auto-HSCT), in patients at high risk of relapse or progression	brentuximab vedotin (up to 16 cycles)	Low	Low	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Moskowitz CH et al. DOI:https://doi.org/10.1016/S0140-6736(15)60165-9 Moskowitz CH et al. https://doi.org/10.1182/blood-2018-07-861641
Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL)
Primary or Initial Therapy	R-ABVD (rituximab, doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Canellos GP, et al. N Engl J Med. 1992;327(21): 1478-84.
	R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Unal A, et al. Leuk Lymphoma. 2005;46(11):1613-7. Fanale MA, et al. Blood. 2010;116(21):abstr 2812.
	R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)	Low	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Shankar A, et al. Eur J Cancer. 2012;48(11):1700-6. Eichenauer DA, et al. J Clin Oncol. 2015;33(26):2857-62.
Relapsed/Refractory	R-ABVD (rituximab, doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Canellos GP, et al. N Engl J Med. 1992;327(21):1478-84. Ekstrand BC, et al. Blood. 2003;101(11):4285-9.
	R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)	Intermediate	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Unal A, et al. Leuk Lymphoma. 2005;46(11):1613-7. Fanale MA, et al. Blood. 2010;116(21):abstr 2812.
	R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)	Low	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Shankar A, et al. Eur J Cancer. 2012;48(11):1700-6. Eichenauer DA, et al. J Clin Oncol. 2015;33(26):2857-62.
	R-DHAP (rituximab, dexamethasone, cytarabine and cisplatin)	High	Moderate	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Josting A, et al. Ann Oncol. 2002;13(10):1628-35. Schulz H, et al. Blood. 2008;111(1):109-111.
	R-ICE (rituximab, iosfamide, carboplatin and etoposide)	High	High	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016. Advani RH, et al. J Clin Oncol. 2014;32(9):912-8. Schulz H, et al. Blood. 2008;111(1):109-11. Eichenauer DA, et al. J Clin Oncol. 2015;33(26):2857-62.
	rituximab	Low	Low	NCCN Guidelines® for Hodgkin Lymphoma V.3.2016.
	Best Supportive Care or Clinical Trial	Not Applicable	Not applicable	Best Supportive Care or Clinical Trial

Classical Hodgkin Lymphoma (CHL)

Primary or Initial Therapy

Evolent Pathways

ABVD (doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

nivolumab + AVD (doxorubicin, vinblastine sulfate, and dacarbazine)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Relapsed/Refractory

Evolent Pathways

ABVD (doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

ICE (ifosfamide, carboplatin and etoposide)

Febrile Neutropenic Risk

high

Emetogenic Risk

high

References

Evolent Pathways

GCD (gemcitabine, carboplatin and dexamethasone)

Febrile Neutropenic Risk

low

Emetogenic Risk

high

References

Evolent Pathways

DHAP (dexamethasone, cytarabine and cisplatin)

Febrile Neutropenic Risk

high

Emetogenic Risk

moderate

References

Evolent Pathways

GVD (gemcitabine, vinorelbine and doxil)

Febrile Neutropenic Risk

low

Emetogenic Risk

moderate

References

Evolent Pathways

MINI-BEAM (carmustine, etoposide, cytarabine and melphalan)

Febrile Neutropenic Risk

high

Emetogenic Risk

moderate

References

Evolent Pathways

MINE (mesna, ifosfamide, novantrone and etoposide)

Febrile Neutropenic Risk

high

Emetogenic Risk

moderate

References

Evolent Pathways

pembrolizumab

Febrile Neutropenic Risk

low

Emetogenic Risk

low

References

Evolent Pathways

Best Supportive Care or Clinical Trial

Febrile Neutropenic Risk

Emetogenic Risk

References

Consolidation/Maintenance therapy after autologous hematopoietic stem-cell transplantation (auto-HSCT), in patients at high risk of relapse or progression

Evolent Pathways

brentuximab vedotin (up to 16 cycles)

Febrile Neutropenic Risk

low

Emetogenic Risk

low

References

Nodular Lymphocyte-Predominant Hodgkin Lymphoma (NLPHL)

Primary or Initial Therapy

Evolent Pathways

R-ABVD (rituximab, doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)

Febrile Neutropenic Risk

low

Emetogenic Risk

moderate

References

Relapsed/Refractory

Evolent Pathways

R-ABVD (rituximab, doxorubicin, bleomycin sulfate, vinblastine sulfate, and dacarbazine)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone)

Febrile Neutropenic Risk

intermediate

Emetogenic Risk

high

References

Evolent Pathways

R-CVP (rituximab, cyclophosphamide, vincristine, prednisone)

Febrile Neutropenic Risk

low

Emetogenic Risk

moderate

References

Evolent Pathways

R-DHAP (rituximab, dexamethasone, cytarabine and cisplatin)

Febrile Neutropenic Risk

high

Emetogenic Risk

moderate

References

Evolent Pathways

R-ICE (rituximab, iosfamide, carboplatin and etoposide)

Febrile Neutropenic Risk

high

Emetogenic Risk

high

References

Evolent Pathways

rituximab

Febrile Neutropenic Risk

low

Emetogenic Risk

low

References

Evolent Pathways

Best Supportive Care or Clinical Trial

Febrile Neutropenic Risk

Emetogenic Risk

References

	Regimen	Alternative	References
LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES
Subsequent Therapy	brentuximab vedotin and nivolumab	Alternative: brentuximab vedotin or nivolumab

LOW VALUE REGIMENS (NON-PATHWAY) WITH SUPERIOR ALTERNATIVES

Subsequent Therapy

Regimen

** brentuximab vedotin and nivolumab **

Pathways and Low-Value Regimens

Hodgkin's Lymphoma