Prophylactic use of filgrastim with ABVD and BEACOPP chemotherapy regimens for Hodgkin lymphoma.

ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) and BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone) are the most widely used regimens for the treatment of patients with advanced stage Hodgkin lymphoma. Both regimens are associated with significant neutropenia. Maintaining the planned dose intensity is considered an important goal to achieve when using curative therapy. Therefore, prophylactic use of granulocyte colony-stimulating factor (G-CSF) is widely used to support these regimens and is mandatory to support BEACOPP-escalated and BEACOPP-14 to reduce toxicity and treatment delays. Recent retrospective studies are discussed which have reported using ABVD without G-CSF support. However, randomized studies are needed to clarify the role of primary prophylaxis with ABVD and BEACOPP-baseline regimens. Secondary prophylaxis should be considered in all patients, especially those who develop neutropenic fever.

Targeting lymphoma cells and their microenvironment with novel antibodies.

Novel monoclonal antibodies are currently being evaluated and have been shown to have significantly influenced the treatment of Hodgkin's and non-Hodgkin's lymphoma. It is of the utmost importance to reduce treatment-related toxicity and, hopefully, improve the cure rate of lymphoma. This is possible by using novel therapies such as monoclonal antibodies, which target tumor cells while sparing normal cells. Investigational antibody therapies include those targeting malignant cells as well as those targeting the microenvironment. Continued investigation is encouraged to combine monoclonal antibodies with other targeted therapies and incorporate their use into standards of care in the treatment of lymphoma.

Hodgkin's lymphoma: molecular targets and novel treatment strategies.

The WHO classification of Hodgkin's lymphoma (HL) distinguishes between two major subtypes, classical and nodular lymphocyte predominant HL. Approximately 95% of patients with HL will have the classical HL histology, which is characterized by the presence of rare malignant Hodgkin's and Reed-Sternberg cells among an overwhelming number of benign reactive cells. In recent years, new studies have shed more light on the biological and molecular features of Hodgkin's and Reed-Sternberg cells, providing hope that new targeted therapy may be developed to enhance the cure rate and to reduce treatment-related toxicity. In this review, the current understanding of the pathology and biology of HL will be discussed, as well as the current treatment approaches for patients with classical HL. Future treatment strategies will also be discussed based on our understanding of HL biology.

The lymphomas: molecular pathways and novel therapeutic targets.

In recent years, several molecular mechanisms involved in promoting cancer cell survival and growth have been identified. These discoveries helped in designing and testing novel drugs that target specific cellular pathways. In this review, we focus on new molecular targets that are currently being explored for the treatment of non-Hodgkin's lymphoma and Hodgkin's lymphoma.