Hodgkin Lymphoma: Present Status and Future Strategies

Dear Colleagues,

Hodgkin Lymphoma (HL) remains unique lymphoid neoplasm with a peculiar tumoral architecture, a distinct pathobiology consisting in few neoplastic cells immortalized by a cytokine network produced by a predominant compartment of non-neoplastic cells and a favorable treatment outcome. Thanks to a great progress in understanding the disease biology, challenging and evolving treatment approaches have been proposed, leading to impressive success in long-term outcomes. As a consequence, with as much as 80% of the treated patients becoming long disease survivors, the issue of late effects of therapy has become an unmet need of particular importance.

Moving from the Ann Arbor conference held in the seventies of the past century, HL has remained the archetype for lymphoma staging and restaging procedures. In the millennium turnaround FDG-PET and later FDG-PET/CT in a single shot imaging session superseded the traditional radiological tools and became a new paradigm for lymphoma spread detection and treatment response assessment. Remarkably, the last surviving invasive tool of the surgical staging, the bone marrow trephine biopsy, proved no longer necessary in the PET era. Early chemosensitivity assessment during treatment with interim PET paved the way to PET-adapted treatment strategies in the first-line setting, in a personalized medicine approach. This treatment individualization proved able to preserve high cure rates and with less treatment-related toxicity. New PET-derived imaging tools extracted from the PET performed at baseline for staging purposes such as Metabolic Tumor Volume (MTV) and tumor Distance (Dmax) have been recently proposed for a further refinement of a personalized cancer treatment.

Despite the success of the modern chemotherapy in long-term HL control, new non-chemotherapy agents such as Brentuximab Vedotin and PD1 inhibitors have dramatically improved disease-control for relapsed/refractory cases. As in other lymphoma subsets, tumor cell DNA shed by the neoplastic cells in the bloodstream proved a very sensitive tool to monitor patients in CR to detect an impending relapse. However, the pathogenesis of HL still keeps many obscure aspects, and several clinical questions stand unsettled including optimal treatment intensity approaches, prognostic factors, especially in the era of PET/CT, and management of relapsed/refractory patients, especially in cases heavily pretreated.

We are pleased to invite you to contribute to this Special Issue of “Cancers” aiming to cover any of these different aspects of Hodgkin Lymphoma. In this Issue we welcome both original research articles and reviews. Research areas may include pathobiology, epidemiology, risk stratification and prognostic factors, treatment strategies and novel agents, PET/CT imaging, and long-term effects and toxicity.

We are looking forward to receiving your contributions.

Prof. Dr. Theodoros P. Vassilakopoulos
Prof. Dr. Andrea Gallamini
Guest Editors

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• Hodgkin Lymphoma
• PET/CT
• patient stratification
• risk-adapted treatment
• prognostic factors
• radiomics
• pathology
• biology
• immunotherapy