J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://jh.elmerpub.com

Original Article

Volume 15, Number 4, August 2026, pages 188-197

Management Patterns and Outcomes for Relapsed or Refractory Hodgkin Lymphoma

↓ Figure 1. CONSORT diagram for patient inclusion. r/r: relapsed or refractory; cHL: classical Hodgkin lymphoma.

↓ Figure 2. Complete response rate (CRR) and overall response rate (ORR) stratified by cytotoxic chemotherapy (Chemo), immune checkpoint inhibitor (ICI) or brentuximab vedotin (BV) alone (ICI/BV alone), and ICI/BV combination regimens (ICI/BV combo).

↓ Figure 3. Kaplan-Meier curves for (a) progression-free survival (PFS) stratified by cytotoxic chemotherapy (Chemo), immune checkpoint inhibitor (ICI) or brentuximab vedotin (BV) alone (ICI/BV alone), and ICI/BV combination regimens (ICI/BV combo); (b) overall survival (OS) for all patients.

↓ **Table 1.** Demographics and Baseline Disease Characteristics
Characteristics	Number of patients (%)
^aIndividual durations were 16, 61, 12, 74, 10, 137, and 165 months. First remission duration was defined as the interval from completion of first-line therapy to first relapse. ABVD: doxorubicin + bleomycin + vinblastine + dacarbazine; BV-AVD: brentuximab vedotin + doxorubicin + vinblastine + dacarbazine; BEACOPP: bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine + prednisone.
Gender
Male	10 (48)
Female	11 (52)
Age
Median	43
Range	24–62
Race/ethnicity
Hispanic	15 (71)
Black	3 (14)
White	1 (5)
Pacific Islander	1 (5)
Unknown	1 (5)
Stage
I	1 (5)
II	9 (43)
III	2 (10)
IV	9 (43)
First-line treatment
ABVD	18 (86)
BV-AVD	2 (10)
BEACOPP	1 (5)
Disease status
Primary refractory	14 (67)
Relapsed	7 (33)
First remission duration (relapsed)^a
Median	61
Range	10–165
Histopathologic subtype
Nodular sclerosis	8 (38)
Mixed cellularity	5 (24)
Lymphocyte-rich	0
Lymphocyte-depleted	0
Unspecified	8 (38)

↓ Table 1. Demographics and Baseline Disease Characteristics

Characteristics

Number of patients (%)

^aIndividual durations were 16, 61, 12, 74, 10, 137, and 165 months. First remission duration was defined as the interval from completion of first-line therapy to first relapse. ABVD: doxorubicin + bleomycin + vinblastine + dacarbazine; BV-AVD: brentuximab vedotin + doxorubicin + vinblastine + dacarbazine; BEACOPP: bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine + prednisone.

Gender

Male

10 (48)

Female

11 (52)

Age

Median

Range

24–62

Race/ethnicity

Hispanic

15 (71)

Black

3 (14)

White

1 (5)

Pacific Islander

1 (5)

Unknown

1 (5)

Stage

1 (5)

9 (43)

III

2 (10)

9 (43)

First-line treatment

ABVD

18 (86)

BV-AVD

2 (10)

BEACOPP

1 (5)

Disease status

Primary refractory

14 (67)

Relapsed

7 (33)

First remission duration (relapsed)^a

Median

Range

10–165

Histopathologic subtype

Nodular sclerosis

8 (38)

Mixed cellularity

5 (24)

Lymphocyte-rich

Lymphocyte-depleted

Unspecified

8 (38)

↓ **Table 2.** Therapies Used for Relapsed / Refractory Disease and Response Rates
	Complete response rate (CRR)	Overall response rate (ORR)
BV: brentuximab vedotin; DHAP: dexamethasone + high-dose cytarabine + cisplatin; GemOx: gemcitabine + oxaliplatin; GVD: gemcitabine + vinorelbine + liposomal doxorubicin; ICE: ifosfamide + carboplatin + etoposide; ICI: immune checkpoint inhibitor; IGEV: ifosfamide + gemcitabine + vinorelbine; Nivo-ICE: nivolumab + ifosfamide + carboplatin + etoposide; NE: not evaluable.
Cytotoxic chemotherapy (n = 16)	25%	50%
ICE (n = 11)	18%	55%
GemOx (n = 3)	33%	33%
IGEV (n = 1)	100%	100%
DHAP (n = 1)	0%	0%
ICI/BV alone (n = 12)	42%	58%
BV (n = 7)	43%	71%
Pembrolizumab (n = 4)	50%	50%
Nivolumab (n = 1)	0%	0%
ICI/BV combination (n = 8)	75%	100%
Nivo-ICE (n = 4)	75%	100%
BV-Nivolumab (n = 1)	100%	100%
BV-ICE (n = 1)	100%	100%
Pembrolizumab-GVD (n = 1)	100%	100%
Pembrolizumab + vorinostat (n = 1)	0%	100%
Other (n = 1)
Everolimus (n = 1)	NE	NE

↓ Table 2. Therapies Used for Relapsed / Refractory Disease and Response Rates

Complete response rate (CRR)

Overall response rate (ORR)

BV: brentuximab vedotin; DHAP: dexamethasone + high-dose cytarabine + cisplatin; GemOx: gemcitabine + oxaliplatin; GVD: gemcitabine + vinorelbine + liposomal doxorubicin; ICE: ifosfamide + carboplatin + etoposide; ICI: immune checkpoint inhibitor; IGEV: ifosfamide + gemcitabine + vinorelbine; Nivo-ICE: nivolumab + ifosfamide + carboplatin + etoposide; NE: not evaluable.

Cytotoxic chemotherapy (n = 16)

25%

50%

ICE (n = 11)

18%

55%

GemOx (n = 3)

33%

IGEV (n = 1)

100%

DHAP (n = 1)

ICI/BV alone (n = 12)

42%

58%

BV (n = 7)

43%

71%

Pembrolizumab (n = 4)

50%

Nivolumab (n = 1)

ICI/BV combination (n = 8)

75%

100%

Nivo-ICE (n = 4)

75%

100%

BV-Nivolumab (n = 1)

100%

BV-ICE (n = 1)

100%

Pembrolizumab-GVD (n = 1)

100%

Pembrolizumab + vorinostat (n = 1)

100%

Other (n = 1)

Everolimus (n = 1)

↓ **Table 3.** Adverse Events (AEs) Observed With the Four Most Common Regimens in Number (%) of Patients
	ICE (n = 11)	Brentuximab vedotin (n = 7)	Nivo-ICE (n = 4)	Pembrolizumab (n = 4)
ICE: ifosfamide + carboplatin + etoposide.
Overall	9 (82)	4 (36)	7 (100)	2 (29)	4 (100)	1 (25)	4 (100)	0
Blood and lymphatic
Febrile neutropenia	1 (9)	1 (9)	0	0	1 (25)	1 (25)	0	0
Neutropenia	4 (36)	4 (36)	1 (14)	0	2 (50)	1 (25)	0	0
Thrombocytopenia	5 (45)	2 (18)	1 (14)	0	3 (75)	1 (25)	0	0
Cardiac
Atrial fibrillation	0	0	0	0	1 (25)	1 (25)	0	0
Heart failure	0	0	0	0	1 (25)	0	0	0
Endocrine
Hypothyroidism	0	0	0	0	1 (25)	0	0	0
Gastrointestinal
Constipation	2 (18)	0	0	0	0	0	0	0
Gastritis	0	0	0	0	0	0	1 (25)	0
Hyperbilirubinemia	0	0	2 (29)	0	1 (25)	0	0	0
Nausea	4 (36)	0	4 (57)	0	1 (25)	0	0	0
Transaminitis	3 (27)	0	1 (14)	0	2 (50)	1 (25)	0	0
Vomiting	1 (9)	0	1 (14)	0	0	0	0	0
General
Fatigue	1 (9)	0	1 (14)	0	3 (75)	0	2 (50)	0
Infections
Conjunctivitis	1 (9)	0	0	0	0	0	0	0
Kidney Infection	0	0	1 (14)	1 (14)	0	0	0	0
Musculoskeletal
Back pain	0	0	0	0	0	0	1 (25)	0
Bone pain	0	0	0	0	0	0	1 (25)	0
Muscle cramp	1 (9)	0	0	0	0	0	0	0
Myalgias	1 (9)	0	0	0	1 (25)	0	0	0
Nervous system
Dizziness	0	0	0	0	1 (25)	0	0	0
Dysgeusia	0	0	1 (14)	0	0	0	0	0
Encephalopathy	1 (9)	0	0	0	0	0	0	0
Headache	1 (9)	0	0	0	0	0	1 (25)	0
Peripheral sensory neuropathy	1 (9)	0	3 (43)	0	1 (25)	0	0	0
Renal
Acute kidney injury	1 (9)	1 (9)	1 (14)	1 (14)	0	0	0	0
Hematuria	3 (27)	0	0	0	1 (25)	0	0	0
Skin
Alopecia	1 (9)	0	0	0	0	0	0	0
Palmar plantar erythrodysesthesia	1 (9)	0	0	0	0	0	0	0
Pruritus	0	0	0	0	0	0	2 (50)	0
Rash acneiform	0	0	0	0	0	0	1 (25)	0

↓ Table 3. Adverse Events (AEs) Observed With the Four Most Common Regimens in Number (%) of Patients

ICE (n = 11)

Brentuximab vedotin (n = 7)

Nivo-ICE (n = 4)

Pembrolizumab (n = 4)

Any grade

Grade 3 or worse

Any grade

Grade 3 or worse

Any grade

Grade 3 or worse

Any grade

Grade 3 or worse

ICE: ifosfamide + carboplatin + etoposide.

Overall

9 (82)

4 (36)

7 (100)

2 (29)

4 (100)

1 (25)

4 (100)

Blood and lymphatic

Febrile neutropenia

1 (9)

1 (25)

Neutropenia

4 (36)

1 (14)

2 (50)

1 (25)

Thrombocytopenia

5 (45)

2 (18)

1 (14)

3 (75)

1 (25)

Cardiac

Atrial fibrillation

1 (25)

Heart failure

1 (25)

Endocrine

Hypothyroidism

1 (25)

Gastrointestinal

Constipation

2 (18)

Gastritis

1 (25)

Hyperbilirubinemia

2 (29)

1 (25)

Nausea

4 (36)

4 (57)

1 (25)

Transaminitis

3 (27)

1 (14)

2 (50)

1 (25)

Vomiting

1 (9)

1 (14)

General

Fatigue

1 (9)

1 (14)

3 (75)

2 (50)

Infections

Conjunctivitis

1 (9)

Kidney Infection

1 (14)

Musculoskeletal

Back pain

1 (25)

Bone pain

1 (25)

Muscle cramp

1 (9)

Myalgias

1 (9)

1 (25)

Nervous system

Dizziness

1 (25)

Dysgeusia

1 (14)

Encephalopathy

1 (9)

Headache

1 (9)

1 (25)

Peripheral sensory neuropathy

1 (9)

3 (43)

1 (25)

Renal

Acute kidney injury

1 (9)

1 (14)

Hematuria

3 (27)

1 (25)

Skin

Alopecia

1 (9)

Palmar plantar erythrodysesthesia

1 (9)

Pruritus

2 (50)

Rash acneiform

1 (25)