{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:37:20Z","timestamp":1783075040763,"version":"3.54.6"},"reference-count":22,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2021,1,10]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> We evaluated disease and treatment characteristics of patients with relapse after risk-adapted first-line treatment of early-stage, favorable, classic Hodgkin lymphoma (ES-HL). We compared second-line therapy with high-dose chemotherapy and autologous stem cell transplantation (ASCT) or conventional chemotherapy (CTx). <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> We analyzed patients with relapse after ES-HL treated within the German Hodgkin Study Group HD10+HD13 trials. We compared, by Cox proportional hazards regression, progression-free survival (PFS) after relapse (second PFS) treated with either ASCT or CTx and performed sensitivity analyses with overall survival (OS) from relapse and Kaplan-Meier statistics. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> A total of 174 patients\u2019 disease relapsed after treatment in the HD10 (n = 53) and HD13 (n = 121) trials. Relapse mostly occurred &gt; 12 months after first diagnosis, predominantly with stage I-II disease. Of 172 patients with known second-line therapy, 85 received CTx (49%); 70, ASCT (41%); 11, radiotherapy only (6%); and 4, palliative single agent therapies (2%). CTx was predominantly bleomycin, etoposide, doxorubicin cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP [68%]), followed by the combination regimen of doxorubicin, bleomycin, vinblastine, and dacarbazine (19%), or other regimens (13%). Patients aged &gt; 60 years at relapse had shorter second PFS (hazard ratio [HR], 3.0; P = .0029) and were mostly treated with CTx (n = 33 of 49; 67%) and rarely with ASCT (n = 8; 16%). After adjustment for age and a disadvantage of ASCT after the more historic HD10 trial, we did not observe a significant difference in the efficacy of CTx versus ASCT for second PFS (HR, 0.7; 95% CI, 0.3 to 1.6; P = .39). In patients in the HD13 trial who were aged \u2264 60 years, the 2-year, second PFS rate was 94.0% with CTx (95% CI, 85.7% to 100%) versus 83.3% with ASCT (95% CI, 71.8% to 94.8%). Additional sensitivity analyses including OS confirmed these observations. <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> After contemporary treatment of ES-HL, relapse mostly occurred &gt; 12 months after first diagnosis. Polychemotherapy regimens such as BEACOPP are frequently administered and may constitute a reasonable treatment option for selected patients with relapse after ES-HL. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.20.00947","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T19:59:31Z","timestamp":1602791971000},"page":"107-115","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":10,"title":["Relapse After Early-Stage, Favorable Hodgkin Lymphoma: Disease Characteristics and Outcomes With Conventional or High-Dose Chemotherapy"],"prefix":"10.1200","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9662-9900","authenticated-orcid":false,"given":"Paul J.","family":"Br\u00f6ckelmann","sequence":"first","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Guhl","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolin","family":"Behringer","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3289-3272","authenticated-orcid":false,"given":"Michael","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alden A.","family":"Moccia","sequence":"additional","affiliation":[{"name":"Swiss Group for Clinical Cancer Research, Bern, Switzerland"},{"name":"Department of Internal Medicine II, University Hospital Tuebingen, Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Rank","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, University Hospital of Augsburg, Augsburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Soekler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, University Hospital Tuebingen, Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Vieler","sequence":"additional","affiliation":[{"name":"University Hospital Schleswig-Holstein, Karl Lennert-Cancer Center, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Pabst","sequence":"additional","affiliation":[{"name":"Swiss Group for Clinical Cancer Research, Bern, Switzerland"},{"name":"Department of Medical Oncology, Inselspital, University Hospital and University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1733-6064","authenticated-orcid":false,"given":"Christian","family":"Baues","sequence":"additional","affiliation":[{"name":"Department of Radiooncology and Cyberknife Center, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"von Tresckow","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3782-2158","authenticated-orcid":false,"given":"Peter","family":"Borchmann","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1890-1523","authenticated-orcid":false,"given":"Andreas","family":"Engert","sequence":"additional","affiliation":[{"name":"Department I of Internal Medicine, Center for Integrated Oncology, Aachen Bonn Cologne Duesseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG), University of Cologne, Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2017-10-772665"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1505949"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30215-7"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30093-6"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.9410"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61469-0"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.68.6394"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.00964"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1408648"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)08938-9"},{"key":"B11","volume":"2013","author":"Rancea M","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"B12","first-page":"535","volume":"115","author":"Br\u00f6ckelmann PJ","year":"2018","journal-title":"Dtsch Arztebl Int"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.022"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1080\/10428190500178167"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1990.8.4.623"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19880715)62:2<233::AID-CNCR2820620203>3.0.CO;2-L"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.71.3289"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1000067"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdf271"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3109\/10428190903254383"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.0410"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30167-X"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO.20.00947","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,29]],"date-time":"2022-05-29T07:45:31Z","timestamp":1653810331000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO.20.00947"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,10]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,1,10]]}},"alternative-id":["10.1200\/JCO.20.00947"],"URL":"https:\/\/doi.org\/10.1200\/jco.20.00947","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,10]]},"assertion":[{"value":"2020-09-10","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}