Classical Hodgkin lymphoma (cHL) is a potentially curable disease, with initial therapy achieving long-term remission in approximately 85% of patients with limited-stage and 70% with advanced-stage disease. In limited-stage cHL, treatment strategies are determined based on risk stratification: early favorable disease is treated with ABVD for 2 cycles followed by involved-site radiation therapy (ISRT) of 20 Gy, and early unfavorable disease with ABVD for 4 cycles plus ISRT of 30 Gy. For advanced-stage cHL, 6 cycles of brentuximab vedotin plus AVD (BV-AVD) is the standard of care, while ABVD remains a viable option in elderly patients due to its more favorable tolerability profile. Recent large-scale clinical trials have demonstrated the efficacy of novel front-line regimens incorporating BV or immune checkpoint inhibitors, as well as interim PET-adapted strategies. These findings are driving a shift in treatment paradigms, with growing emphasis on treatment de-escalation and toxicity reduction in patients with favorable early response. This review provides an overview of current front-line treatment strategies for cHL, highlights ongoing challenges, and discusses future directions for therapy optimization.
"},{"@language":"ja","@value":"古典的ホジキンリンパ腫（cHL）は治癒が期待される疾患であり，初回治療により限局期では約85％，進行期では約70％の患者が長期奏効を得る。限局期では適切なリスク分類に基づき，限局期予後良好群にはABVD×2コース＋ISRT 20 Gyを，限局期予後不良群にはABVD×4コース＋ISRT 30 Gyを行うことが基本となる。進行期に対する標準治療はBV-AVD×6コースであり，高齢者cHLでは忍容性を考慮してABVD×6コースも選択肢となる。近年，BVや免疫チェックポイント阻害薬（ICI）を含む初回治療レジメンと中間PETによる層別化治療の有用性を検証した大規模臨床試験の結果により，cHLに対する初回治療戦略は変化しつつある。治療成績の向上に加え，治療反応性が良好な患者群における治療強度の最適化と毒性低減も重要な課題となっている。本稿では，cHLに対する初回治療の現状と課題，今後の展望について概説する。
"}],"abstractLicenseFlag":"disallow"}],"creator":[{"@id":"https://cir.nii.ac.jp/crid/1410024257280503680","@type":"Researcher","foaf:name":[{"@language":"ja","@value":"山内 寛彦"},{"@language":"en","@value":"YAMAUCHI Nobuhiko"}],"jpcoar:affiliationName":[{"@language":"en","@value":"Department of Hematology Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research"},{"@language":"ja","@value":"公益財団法人がん研究会有明病院 血液腫瘍科"}]}],"publication":{"publicationIdentifier":[{"@type":"PISSN","@value":"04851439"},{"@type":"LISSN","@value":"04851439"},{"@type":"EISSN","@value":"18820824"},{"@type":"NDL_BIB_ID","@value":"000000024253"},{"@type":"ISSN","@value":"04851439"},{"@type":"NCID","@value":"AN00252940"}],"prism:publicationName":[{"@language":"en","@value":"Rinsho Ketsueki"},{"@language":"ja","@value":"臨床血液"},{"@language":"en","@value":"Rinsho Ketsueki"},{"@language":"en","@value":"Jpn. J. Clin. Hematol."},{"@language":"en","@value":"The Japanese Journal of Clinical Hematology"},{"@language":"ja","@value":"臨床血液"}],"dc:publisher":[{"@language":"en","@value":"The Japanese Society of Hematology"},{"@language":"ja","@value":"一般社団法人 日本血液学会"}],"prism:publicationDate":"2025","prism:volume":"66","prism:number":"9","prism:startingPage":"1064","prism:endingPage":"1073"},"url":[{"@id":"http://id.ndl.go.jp/bib/034338084"},{"@id":"https://ndlsearch.ndl.go.jp/books/R000000004-I034338084"},{"@id":"https://search.jamas.or.jp/link/ui/2025365268"}],"availableAt":"2025","foaf:topic":[{"@id":"https://cir.nii.ac.jp/all?q=Classic%20Hodgkin%20lymphoma","dc:title":"Classic Hodgkin lymphoma"},{"@id":"https://cir.nii.ac.jp/all?q=Brentuximab%20vedotin%20combined%20with%20AVD","dc:title":"Brentuximab vedotin combined with AVD"},{"@id":"https://cir.nii.ac.jp/all?q=Interim%20PET-adopted%20therapy","dc:title":"Interim PET-adopted therapy"},{"@id":"https://cir.nii.ac.jp/all?q=Classic%20Hodgkin%20lymphoma","dc:title":"Classic Hodgkin lymphoma"},{"@id":"https://cir.nii.ac.jp/all?q=Brentuximab%20vedotin%20combined%20with%20AVD","dc:title":"Brentuximab vedotin combined with AVD"},{"@id":"https://cir.nii.ac.jp/all?q=Interim%20PET-adopted%20therapy","dc:title":"Interim PET-adopted therapy"}],"dataSourceIdentifier":[{"@type":"JALC","@value":"oai:japanlinkcenter.org:2014600546"},{"@type":"NDL_SEARCH","@value":"oai:ndlsearch.ndl.go.jp:R000000004-I034338084"},{"@type":"PUBMED","@value":"41034056"}]}