Hodgkin Lymphoma
Definition, frequency (epidemiology) and causes (etiology)Hodgkin lymphoma (also known as Hodgkin’s lymphoma, Hodgkin’s disease, morbus Hodgkin and lymphogranulomatosis) is a malignant disease of the lymphatic system. With an incidence of 2-3 per 100,000 persons per year, it is a relatively rare disease. It was first described in 1832 by Sir Thomas Hodgkin, after whom it was named. The histologic characteristic of Hodgkin lymphoma is the presence of malignant Hodgkin cells and Reed-Sternberg cells. The detection of these cells allows to distinguish between Hodgkin lymphoma and the large group of the so-called non-Hodgkin lymphomas or other diseases of the lymphatic system. SymptomsSymptoms for Hodgkin lymphoma are painless swellings of the lymph nodes that initially often appear at the neck or beyond the breastbone (mediastinum). The disease may also lead to symptoms that are generally associated with malignant diseases, like fever of unknown origin, unintended weight loss or night sweats (B sypmtoms) as well as tiredness and a decrease in general performance. If organs are affected by the disease, this can also induce specific symptoms and complaints. Histology, diagnostics and disease stagingAn important criterion for the choice of treatment is the stage of disease. In order to identify the stage of disease, it has to be determined to what extent the tumor has spread throughout the body and which risk factors are present. Apart from a physical examination and the taking of the patient’s medical history (anamnesis), a biopsy of a complete involved node and a histologic examination (histology) of this node is required. This allows to identify malignant cells, some of which are located far apart from each other. To detect the exact tumor spread throughout the whole body, a computed tomography (CT), an X ray scan, an ultrasonic examination, a skeletal scintigraphy and a bone marrow biopsy have to be performed. The disease stages are classified according to the Ann Arbor staging system, taking defined risk factors into account. Treatment of Hodgkin lymphomaThe treatment of Hodgkin lymphoma after the initial diagnosis consists in chemotherapy and/or radiation. In order to find a balance between treatment effect and side-effects of treatment, precise disease staging is essential. Whenever possible, a patient should be treated within the framework of a stage-adapted clinical trial, so that the great progress that has been achieved in Hodgkin lymphoma treatment thanks to clinical trials over the last decades can be continued. Adverse reactions and late effectsBoth chemotherapy and radiotherapy may cause averse reactions. These can appear directly (acute) or even years after end of therapy. The most common side-effects are vomiting, loss of hair and changes in the blood count that might lead to serious infections or necessitate the transfusion of blood or blood platelets. Apart from that, the therapy may also cause impairment of the heart, lung, thyroid gland or of the male and female fertility. Within the cause of treatment, further malignant tumors can appear, so-called secondary tumors (secondary malignancies/neoplasias). Also chronic tiredness (fatigue) is a possible side-effect. Prognosis and perspectiveHodgkin lymphoma is a malignant disease that is fatal without treatment in most cases. However, due to stage-adapted treatment and the great improvements in chemotherapy and radiotherapy, Hodgkin lymphoma is today one of the best curable malignant diseases. Even advanced stage Hodgkin lymphoma has a cure rate of 80 90%. Two thirds of all relapses occur during the first two or two and a half years after the initial manifestation of the disease, almost all during the first five years thereafter. Beyond this time, the risk of relapse decreases, but in rare cases also late recurrences are possible. AftercareThe purpose of follow-up examinations is to early detect a relapse or secondary tumors, an early treatment of which may substantially improve a patient’s prognosis. Aftercare is also essential to recognize other late effects as soon as possible. Aftercare should be conducted all life long, though the intervals between the individual examinations may be extended, the more time the disease is dated back. |
News
Das 8. Internationale Hodgkin-Symposium wird vom 23.-26.10.2010 im Kölner Gürzenich statt-finden
Die AVD-Rev Studie wurde bei älteren Hodgkin Lymphom Patienten im Alter von ≥ 60 bis ≤ 75 Jahre in mittleren und fortgeschrittenen Stadien ohne jegliche Vorbehandlung gestartet
