Interim PET/CT-adapted Use of PD-1 Inhibitor Combined With De-escalated Chemotherapy-AVD in Classic Hodgkin Lymphoma

Inclusion Criteria:

• Age ≥ 18 years old;
• Histologically confirmed newly diagnosed classical Hodgkin lymphoma (cHL);
• Eligible to receive standard frontline ABVD induction chemotherapy for 2 cycles;
• Able to complete interim PET-CT (iPET2) scan after 2 cycles ABVD for Deauville score stratification;
• Adequate bone marrow, hepatic and renal function to tolerate chemotherapy and immunotherapy;
• Life expectancy ≥ 6 months at enrollment;
• Willing to comply with scheduled treatment, imaging follow-up and laboratory tests;

Exclusion Criteria:

• Prior systemic anti-lymphoma therapy, including chemotherapy, radiation, anti-PD-1/PD-L1 immunotherapy or stem cell transplantation;
• Severe irreversible organ dysfunction (cardiac, pulmonary, hepatic, renal) that cannot tolerate cytotoxic chemotherapy;
• Known hypersensitivity to doxorubicin, bleomycin, vinblastine, dacarbazine or sintilimab;
• Active severe infection (e.g., uncontrolled sepsis, active tuberculosis, HIV infection);
• Pregnant or breastfeeding female patients;
• Inability to complete serial PET-CT imaging due to contraindications such as severe contrast allergy