Single center experience in patients with a diagnosis of nodular lymphocyte predominant Hodgkin lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma is an infrequent disease. It is associated with a favorable prognosis. The most important problems with the management of the disease are relapses, transformation to non-Hodgkin lymphoma, and treatment-related toxicities. In early stages of disease, watchful waiting, surgery, radiotherapy, and single-agent rituximab are the treatment options. Chemo-immunotherapy may be preferred in early disease with high tumor and symptom burden. In advanced disease, chemo-immunotherapy with or without radiotherapy is used. Good responses can be achieved in relapsed disease. The risk of transformation is high. It is reasonable to obtain re-biopsies at relapses. Transformed disease and the primary disease have been shown to be clonally-related in most cases. Prognosis of transformed disease which is treated with salvage chemo-immunotherapy followed by autologous stem cell transplantation is similar to that of de novo diffuse large B-cell lymphoma. All of the data regarding the treatment come from retrospective data.