New lymphoma therapy boosts young patients’ chances of parenthood
A new therapy for patients suffering from a rare lymphoma proved to be very effective and leave fewer lasting side effects.
Published on October 12, 2026
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Amsterdam University Medical Center (Amsterdam UMC) has switched to a new standard treatment for people with advanced Hodgkin lymphoma, a cancer that often strikes young adults. The new drug combination, BrECADD, keeps the disease away more often than the treatment it replaces and leaves patients with fewer lasting side effects. For many, that means a better chance of having children once the cancer is behind them.
What is Hodgkin lymphoma?
Hodgkin lymphoma is a cancer of the lymphatic system, the network of lymph nodes and vessels that helps the body fight infection. It starts when a type of white blood cell, the B lymphocyte, begins to grow out of control. The first sign is often a painless swollen gland in the neck, armpit or groin, sometimes with fevers, night sweats, weight loss or persistent itching.
The disease is fairly rare: in Western countries there are roughly two to three new cases per 100,000 people each year, or about 450 to 500 in the Netherlands. Unusually for a cancer, it is most common in people in their twenties and early thirties. In the advanced stage, several groups of lymph nodes, and sometimes organs, are affected.
A cure that came at a cost
Hodgkin lymphoma is one of the most curable cancers, and the previous standard treatment worked well. But it was harsh. Patients could face serious infections, anaemia, nerve damage and reduced fertility, and because many are young when diagnosed, those effects can follow them for decades.
For young patients, says Josée Zijlstra, professor of haematology at Amsterdam UMC, the real question is not only whether they are cured. It is whether they can pick up their lives afterwards and still start a family.
What is different
The new approach comes from HD21, a large international trial whose Dutch arm Zijlstra led. It compared the old regimen with BrECADD, a combination of chemotherapy and immunotherapy. Three medicines linked to lung damage, nerve damage and infertility were dropped and replaced by drugs with milder side effects. Among them is brentuximab vedotin, which homes in on the lymphoma cells and delivers its chemotherapy directly to them.
Treatment is also tailored to each patient. After two cycles, patients get a positron emission tomography (PET) scan, which uses a radioactive tracer to detect diseases. If it shows no remaining active disease, four cycles in total are enough; if it does, they receive six. As a result, most patients now need only four.
Better results, fewer side effects
About 1,500 patients from nine countries took part. Four years on, the disease had not returned or worsened in 94% of those treated with BrECADD, against 91% on the older regimen. Serious side effects were also less common: 42% compared with 59%.
For patients, the long-term picture matters most. Ovaries and testes recovered their function more often after BrECADD, improving the chances of conceiving naturally later. Patients also needed fewer blood transfusions and had less nerve damage, such as numbness or tingling. The new treatment, Zijlstra says, "works better and is easier to tolerate."
Now the standard in the Netherlands
BrECADD is now the preferred treatment in the Netherlands for people up to age 60 with advanced Hodgkin lymphoma. Health insurers have covered it since August 2025, and it has now been added to the national treatment guideline, making it standard care.
The Dutch part of the research was funded by KWF, the Dutch Cancer Society, with money raised entirely through Alpe d'HuZes, the charity event in which participants climb the Alpe d'Huez to fight cancer. That support allowed Dutch patients to join a study whose benefits are now reaching the consulting room.