Personalized Reduction of Chemotherapy Intensity Through ctDNA Evaluation for the Treatment of Patients With Advanced Hodgkin Lymphoma

This study tests whether tracking tumor DNA fragments in the blood (called ctDNA) during treatment can guide doctors to safely reduce chemotherapy intensity for people with advanced (Stage 3 or 4) Hodgkin lymphoma — potentially reducing side effects while maintaining effectiveness. **You may be eligible if...** - You are 18 or older - You have been newly diagnosed with Stage 3 or 4 classical Hodgkin lymphoma and have not yet started systemic treatment - You have measurable disease - You are well enough to receive 6 cycles of chemotherapy including an anthracycline (a type of chemotherapy drug) - Your blood counts, liver, and kidney function are adequate **You may NOT be eligible if...** - You have cancer spread to the brain - You have untreated HIV or active hepatitis B or C with a detectable viral load - You are pregnant or breastfeeding - You have another active cancer (except treated skin cancer or cervical carcinoma in situ) - You have significant heart disease (recent heart attack, uncontrolled arrhythmia, or weak heart pumping function) - You currently need supplemental oxygen - You have active autoimmune disease (except vitiligo or controlled thyroid disease) Talk to your doctor to see if this trial is right for you.