Recurrent Hodgkin lymphoma means the cancer returns after treatment and remission. In many cases, further treatments can help achieve remission or a possible cure.

Hodgkin lymphoma (HL) is a type of cancer that begins in lymphocytes, a type of white blood cell that forms part of the lymphatic system.

Recurrent HL is the term for HL that returns after treatment and a period of remission. This article explores what recurrent HL means, including diagnosis, treatment options, and outlook.

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Whether recurrent or in relapse, HL is the term for HL that returns after treatment.

According to the Lymphoma Research Foundation, recurrent HL means the cancer regrows or reappears after a period of remission.

According to a 2021 review, relapse can occur in up to 30% of people with the advanced stages of HL and 5–10% of those in the earlier stages of the disease where it has not spread.

If doctors suspect a HL relapse, they may carry out various tests, such as:

  • Blood tests: These measure the levels of blood cells people have, as lymphoma can cause low blood counts and other abnormalities in the blood that may indicate HL.
  • Scans: These include CT scans or ultrasounds to look for enlarged lymph nodes and to check if the cancer has spread.
  • Biopsy: This procedure involves taking a sample from a lymph node to test for lymphoma.

The test results will help doctors identify if the HL has returned, and if it has, what type and stage the lymphoma is and the best treatment strategy.

Learn about the stages of lymphoma.

To treat recurrent HL, people will usually have second-line chemotherapy treatment. This involves different drugs from the chemotherapy they may have received as part of the initial treatment. This may include single or combination drugs, such as:

  • ICE chemotherapy, which includes ifosfamide, carboplatin, and etoposide
  • gemcitabine-containing chemotherapy regimens, such as gemcitabine, vinorelbine, and pegylated liposomal doxorubicin, known as GVD
  • targeted chemotherapy, such as brentuximab and bendamustine
  • immunotherapy, such as nivolumab

Following chemotherapy treatment, people will then typically have a stem cell transplant.

Learn more about chemotherapy for lymphoma.

Treatments undergoing research

Clinical trials are currently researching new treatment options for recurrent HL in addition to those available at the moment. Drugs under investigation include the following:

  • AB-205
  • anti-CD30-chimeric antigen receptor T cells
  • atezolizumab
  • bortezomib
  • camidanlumab tesirine
  • camrelizumab
  • carfilzomib
  • everolimus
  • ibrutinib
  • itacitinib
  • ipilimumab
  • lenalidomide
  • magrolimab
  • mocetinostat
  • pralatrexate
  • romidepsin
  • ruxolitinib
  • tislelizumab
  • umbralisib

People can speak with a doctor about the latest research and treatments for recurrent HL, whether any new treatments are available, or if they are interested in joining a clinical trial.

Doctors may treat recurrent HL with a stem cell or bone marrow transplant.

Doctors first use high dose chemotherapy to destroy both healthy and cancer cells in bone marrow.

Following chemotherapy, a stem cell transplant replaces all these cells with healthy stem cells. Doctors collect these from the person undergoing the transplantation or a donor.

For HL, there are two types of stem cell transplant that people may have:

  • Autologous: Doctors take stem cells from a person’s blood or bone marrow to replace the cells. This is the most common form of transplant for HL.
  • Allogeneic: If an autologous transplant is ineffective, people have insufficient healthy stem cells for transplantation, or if the cancer has spread to bone marrow, individuals may have an allogeneic transplant. This uses stem cells from a donor.

Second-line treatments are usually effective in treating recurrent HL and may lead to a second remission or potentially cure the disease.

The outlook may vary depending on various factors, including the stage of the disease. For earlier stages of HL, the 5-year overall survival may be 90%, and stage 4 cancer may be around 60%.

Certain factors, such as age, overall health, and response to treatment, can also affect a person’s outlook. There is some risk of secondary cancers forming from HL treatments, so attending regular follow-ups is important.

People with recurrent HL may need to attend regular follow-up appointments to monitor their condition.

If a person is in remission, they may require medical tests to assess if they need any further treatment. These tests may include blood tests and scans, such as CT or PET scans.

Keeping hold of all medical records, test results, and information on treatments is important to help people monitor treatment progress. Follow-up care may continue for several years following HL treatment.

There is no evidence that certain lifestyle or dietary changes can help with HL. However, focusing on healthy habits, such as regular exercise and following a balanced diet, can help support overall health.

Here are answers to common questions about recurrent Hodgkin’s lymphoma.

Is recurrent Hodgkin’s lymphoma curable?

According to the Lymphoma Research Foundation, secondary treatments for recurrent HL are usually successful and may lead to a second remission or a cure.

What happens if Hodgkin’s lymphoma comes back?

If doctors diagnose recurrent HL, they will assess the stage and type of lymphoma and the best treatment strategy. In most cases, treatment for recurrent HL includes chemotherapy and a stem cell transplant.

What is the recurrence survival rate of Hodgkin lymphoma?

According to a small 2021 study examining HL relapse for people with event-free survival, the 2-year overall survival and disease-specific survival were more than 90%.

Other factors, such as the stage of the cancer, age, overall health, and type of treatment, may affect survival rates.

How common is Hodgkin’s lymphoma relapse?

Initial treatment for HL has a high cure rate. Up to 30% of people with advanced stage HL may relapse after treatment results in complete remission. Additionally, 5–10% of people with limited stage HL may relapse.

Most cases of recurrent classical HL usually occur within 3 years of the initial HL diagnosis, although some relapses can happen later. The risk of HL relapse may decrease after 2 years.

Recurrent Hodgkin’s lymphoma involves the cancer returning after treatment leads to remission.

Treatment may involve high dose chemotherapy and stem cell transplants. Treatment may result in another remission or may even cure HL.