肿瘤学临床实践指南（NCCN Guidelines 霍奇金淋巴瘤

1 NCCN NCCN Guidelines NCCN 2017 1 2017 3 1 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) NCCN Guidelines for Patients NCCN 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) NCCN 2017 1 **Richard T. Hoppe / Ranjana H. Advani / Weiyun Z. Ai (UCSF) Richard F. Ambinder Patricia Aoun Celeste M. Bello Cecil M. Benitez Karl Bernat Philip J.

2 Bierman x Kristie A. Blum - Solove Robert Chen x Bouthaina Dabaja MD Andres Forero Leo I. Gordon H Francisco J. Hernandez-Ilizaliturri Ephraim P. Hochberg Jiayi Huang - Patrick B. Johnston Mark G. Kris Vaishalee P. Kenkre Carbone Nadia Khan David G. Maloney / Peter M. Mauch / Monika Metzger / Joseph O. Moore David Morgan x - Craig H.

3 Moskowitz Carolyn Mulroney x Matthew Poppe Rachel Rabinovitch Stuart Seropian / Mitchell Smith / Jane N. Winter H Joachim Yahalom NCCNJ ennifer BurnsNdiya Ogba Hema Sundar NCCN / x * NCCN NCCN NCCN 2A NCCN NCCN (HODG-1) (HODG-2) (CHL) CS IA-IIA (HODG-3, HODG-4, HODG-5)CS I-II (HODG-6)CS I-II >10 cm (HODG-7)CS III-IV (HODG-10) (NLPHL) CS IA-IVB (HODG-13) (HODG-14) CHL (HODG-15)CHL (HODG-16)NLPHL (HODG-17)

4 I-II CHL (HODG-A) (HODG-B) (HODG-C)PET 5 Deauville (HODG-D) (HODG-E) CHL (HODG-F) (ST-1) NCCN Guidelines NCCN NCCN National Comprehensive Cancer Network , NCCN NCCN (National Comprehensive Cancer Network ) NCCN NCCN 2017 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) NCCN 2017 1 NCCN NCCN (NCCN Guidelines for Patients 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) NCCN 2017 1 NCCN 2017 1 2016 3 GHSG HD10 Engert A N Engl J Med 2010;363:640-652.)

5 RAPID Radford J N Engl J Med 2015;372:1598-1607. EORTC/LYSA/FIL H10 Raemaekers JM J Clin Oncol 2014;32:1188-1194. Stanford G4 Advani RH Ann Oncol 2013;24:1044-1048. GHSG HD14 von Tresckow B J Clin Oncol 2012;30:907-913. RATHL Johnson PW N Engl J Med 2016; 374:2419-2429. GHSG HD11 Eich HT J Clin Oncol 2010;28:4199-4206. ECOG E2496 Gordon LI J Clin Oncol 2013;31:684-691. GHSG HD15 Engert A Lancet 2012; 379(9828) PET/CT (skull base to mid-thigh) PET/CT CT MRI PET/MRI a (FNA) (FNA) f.

6 NCCN B HODG-2 CHL IIA E 4 ESR >50 HODG-4 j HD10 E Engert A N Engl J Med 2010; 363:640-652. HODG-3 HODG-4 HODG-4 IIA HODG-4 IA-IIA <4 ESR <50, E- ) ABVD .. v 2 PET/CT ABVD x 2 Deauville 1-2 ABVD x 1 2 3 4 + ISRT (30 Gy)HODG-6 ABVD 4 2 Deauville 1-3 1-2 / ABVD x 2 4 + ISRT AVD x 4 6 ISRT ISRT Deauville 4 3-4 BEACOPP x 2 PET/CT ISRT Deauville 5 ABVD AVD x 4 HODG-7 ABVD 4 2 1 Deauville 1-3 ABVD x 2 4 6 + ISRT AVD x 4 6 ISRT ISRT Deauville 4 ABVD x 2 4 6 + ISRT BEACOPP x 2 + ISRT (30 Gy)

7 NCCN 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) NCCN 2017 1 NCCN 2017 1 2016 3 HODG-10 ABVD 2 ABVD Deauville 1-3 ABVD x 4 6 Deauville 4-5 BEACOPP x 4 ABVD x 2 4 4 BEACOPP ABVD ABVD x 2 4 Deauville 1-3 4-5 PET ABVD x 2 6 ISRT HODG-13 CS IA-IIA ISRT IA IIA CS IB-IIB I-IIA + CS III-IVA III-IVB CS IIIA-IVA HODG-14 5 / / / CT 6.

8 5 CT 40 50 10 ACS ACS 55-75 15 30 CT HODG-15 HDT/ASCR Deauville 1-3 HDT/ASCR brentuximab vedotin 1 < 12 HDT/ASCR Deauville 4 HDT/ASCR brentuximab vedotin 1 <12 ISRT ISRT IFRT HDT/ASCR 2 brentuximab vedotin HODG-B (1/2) ABVD HODG-B (2/2) + HODG-C (1/3) ISRT PET Deauville 3-4 30-45 Gy ISRT Gy HODG-E (1/2) Nivolumab CHL HDT/ASCR brentuximab vedotin nivolumab pembrolizumab brentuximab vedotin HODG-E (2/2) pembrolizumab Armand P Shipp MA Ribrag V brentuximab vedotin pembrolizumab [ ] -1 J Clin Oncol 2016.

9 34(31):3733-3739 HODG-F I-II III-IV PVAG 6-8 6 Nivolumab brentuximab vedotin MS-1 NCCN NCCN 2017 1 18 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) 2A NCCN NCCN HODG-1 a b B > 38 C 6 10% CBC (ESR) (LDH) (LFT) CTc PET/CT d NCCN e PET/CT CT ABVD BEACOPP PFT [DLCO] H HIV / X PET h MRI PET/MRI ( )a , (FNA) b CD15+ CD30+ PAX-5+ CD3- CD20- CD45- CD79a- CD20+ CD45+ CD79a+ BCL6+ PAX-5+ CD3- CD15- CD30- Swerdlow SH, Campo E, Harris NL, et al.

10 WHO classification of tumours of haematopoietic and lymphoid , France: IARC; 2008 NCCN B c CT CT PET/CT CT CT / / / PET/CT (CHL)f (NLPHL)gd PET/CT PET HL HIV (ST-1) e IVF fCHL (NSHL) (MCHL) (LDHL) (LRHL) NCCN B g (CHL) (NLPHL) I-II NLPHL h PET/CT PET/CT HODG-13 HODG-2 NCCN 2017 1 18 2017 1 2017 3 1 2017 NCCN NCCN Guidelines (NCCN ) 2A NCCN NCCN i i (ESR) IA 1<50 HODG-3 HODG-4IB 1 HODG-6 IIA (E) <3<50 HODG-3 HODG-4 IIA (E) j <4<50 HODG-4 4 50 HODG-4 HODG-6 HODG-7 IIB (E) j HODG-6 HODG-7 III-IV / HODG-10 (CHL)