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Purpose: The purpose of this study was to evaluate the clinical characteristics, prognostic factors, therapy and outcomes of patients with very late relapse (>5 years) of Hodgkin's lymphoma (HL)., Methods: We retrospectively reviewed the database of all relapsed patients with HL treated between 1999 and 2009 and compared the clinical characteristics and survival of patients who relapsed before and after 5 years of follow up., Results: Among the group of 102 patients with relapsed HL 16 (15.68%) patients had very late relapse of disease. Median time to very late relapse was 86 months (range 61- 199). On relapse most of these patients (11; 68.5%) were in advanced clinical stage. Eleven (68.75%) patients with very late relapse were treated with high dose chemotherapy and autologous stem cell transplantation (ASCT). Second complete response was achieved in 13 (81.25%) patients. At a median follow up of 4.5 years after therapy, 13 (81.25%) patients are still alive (10 without disease and 3 with disease), while 3 patients died (2 from HL, and 1 from brain tumor). There was no significant difference between patients with very late relapse and patients who relapse earlier in terms of initial clinical parameters. Median overall survival of patients with very late relapse was significantly longer than in patients with earlier relapse (p=0.001), but survival calculated from the time оf relapse was not significantly different between these two groups of patients (p=0.83)., Conclusion: An open question that remains is whether high dose therapy and ASCT is necessary in most patients with very late relapse of disease. Individualization of therapy in patients with very late relapse of HL is mandatory, tailored on risk factors and comorbidities.

Introduction: Post-transplant lymphoproliferative disease (PTLD) comprises a variety of lymphoid and plasma cell disorders arising in patients with a solid organ transplant. Monomorphic lymphomas represent the most significant part of this wide spectrum, with the overall risk rising with the aggressiveness of lymphoid proliferation in comparison to the general population. The development of Hodgkin lymphoma is very rare in transplant recipients, comprising less than 6% of all monomorphic PTLD, while cases of primary intestinal Hodgkin lymphoma in these circumstances are anecdotal., Case Report: We describe an exceptional case of intestinal Hodgkin lymphoma mimicking an intra-abdominal abscess that developed in a transplant recipient 19 years after kidney transplantation. By presenting this case, we wish to emphasize the importance of suitable diagnostic pathways in transplant recipients experiencing prolonged fever episodes or masses of unknown origin, thus raising the awareness of possible PTLD development in such patients., Conclusion: The lack of information about transplant recipients with Hodgkin PTLD regarding the site of involvement and type of treatment suggests the necessity of conducting larger international studies aimed at providing further insight into this particular group of patients., (© 2016 S. Karger GmbH, Freiburg.)

Based on the results of clinical trials, there is no global consensus on the optimal first-line therapy for patients with advanced Hodgkin lymphoma (HL) with both ABVD and BEACOPP currently being used. However, the results of clinical trials are usually better than those in daily practice. We thus describe here our experience on 314 advanced classical HL patients treated with ABVD at the Clinical Center of Serbia and associated centers between 1997 and 2008. The median follow-up for all patients was 91 months; the estimated 5-yr event-free survival was 62% and the 5-yr overall survival (OS) 76%. Multivariate Cox regression analysis revealed that patients with IPS ≥ 3 and extranodal disease involving more than one site have a poorer outcome. The data presented here show on overall improvement in outcome as compared to more previous data and illustrate the problems of treating advanced stage HL outside the setting of a clinical trial., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)