SOHO 2023 | Diagnosis and risk stratification in Hodgkin lymphoma: updates and novel approaches

In the world of Hodgkin lymphoma, when it comes to diagnosis, I think not a lot has changed in the past year. I think what has changed a little bit is the discussion about what to call nodular lymphocyte-predominant Hodgkin lymphoma, which is a rare subset and whether that should be Hodgkin lymphoma or just a B-cell lymphoma is some measure of debate. As far as risk stratification of patients, I think we’re having greater and greater understanding of who are the patients that are at risk for having less than an optimal outcome with therapy. I think that still comes down to, at this point, PET responses. When patients respond well and when they have less bulky disease, as measured by metabolic tumor volumes, those are the patients that typically may have a better outcome. Not quite yet in standard practice, but hopefully to come, would be the use of soluble proteins and cell-free DNA approaches. But at this point those are not really ready for prime time. So the use of typical immunohistochemistry as diagnostic criteria, and then the use of PET scans as a way to determine response and use that as a predictive outcome is mainly how Hodgkin is being managed.