Is There a Higher Chance of Relapse for Primary Refractory Hodgkin Lymphoma Patients? | Transcript | Hodgkin Lymphoma | Patient Power


Is There a Higher Chance of Relapse for Primary Refractory Hodgkin Lymphoma Patients?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Beth:

The first question is asking how long do you think a child that had primary refractory Hodgkin lymphoma would stay in remission.  This is a two-part question.  Do you think there's a higher chance of relapse once you've done that before and became refractory? 

Let me know if you'd like me to repeat that. 

Dr. Burke:

So let me—I think I'll inadequately tackle the first question.  So just to repeat, my understanding, how long would a child with primary refractory Hodgkin lymphoma remain in remission? 

Beth Probert:

Yes. 

Dr. Burke:

I will say that I don't treat children, so I have zero experience in treating children.  I treat only adults.  Now, naturally, the average age, sort of the peak age for Hodgkin lymphoma is in the late 20s, so I treat a lot of 20-year-olds with Hodgkin lymphoma. 

Primary refractory Hodgkin lymphoma is a tough disease.  You know, primary refractory anything means that when you give chemotherapy it's not working, and that's very unusual.  I'm trying to remember the last case of primary refractory Hodgkin lymphoma that I've seen.  The large majority of patients respond, so an unusual situation.  And I would guess that the prognosis is not great and probably an average survival measured in under a couple years. 

That said, and again I don't know exactly what's available in children, but in adults somebody in their 20s or 30s we would think about some of these novel therapies, and they really can help improve survival.  We are seeing people live longer and longer, particularly with checkpoint inhibitors and brentuximab vedotin (Adcetris).  And really even in patients that I would expect would not live very long with multiply relapsed disease, some of them are going on kind of a long time on checkpoint inhibitor therapy, and it really seems—even if it's not curing patients it's extending their lives.  So that's the best I can do on the first question. 

Help we with the second part of the question again, I can't remember. 

Beth Probert:

Well, and the second part was do you think there's a higher chance of relapse once you have done that before and became refractory?  So you might have wrapped that up in the first part of it.  It was basically would someone have a higher chance of relapse? 

Dr. Burke:

So if a patient has primary refractory Hodgkin lymphoma the question is that patient at higher risk of relapse after getting into remission than somebody who doesn't have primary refractory Hodgkin lymphoma but has just relapsed later, and the answer is that it's better not to be primary refractory.  That is, if I have Hodgkin lymphoma and I get chemo and I go into remission for two years and then I relapse, my prognosis is better than someone who didn't respond at all to that initial therapy but then eventually did get into remission and get a transplant.  So that's the prognostic significance of that primary refractory disease.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on September 4, 2019