Hodgkin's Lymphoma

1/24/2008

Question:  How is Hodgkin's Lymphoma Diagnosed, Staged, and Treated?

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17908627.ui or 17908622.ui or 17631599.ui or 17503349.ui or 17474345.ui or 17296811.ui or 16529147.ui or 12648984.ui

PubMed Recovery String (copy and paste to PubMed entry panel to restore search):

17908627[PMID] OR 17908622[PMID] OR 17631599[PMID] OR 17503349[PMID] OR 17474345[PMID] OR 17296811[PMID] OR 16529147[PMID] OR 12648984[PMID]

<1>

Unique Identifier [PMID]: 17908627

Authors: Diehl V. Engert A. Re D.

Institution: Department of Internal Medicine I, Haus Lebenswert, University Hospital of Cologne, Kerpenerstr. 62, 50931 Cologne, Germany. v.diehl@uni-koeln.de

Title: New strategies for the treatment of advanced-stage Hodgkin's lymphoma. [Review] [35 refs]

Source: Hematology - Oncology Clinics of North America. 21(5):897-914, 2007 Oct.

Abstract: In 2007, patients who have Hodgkin's lymphoma, even in advanced stages, have a better than 85% chance of being cured of their disease if adequate therapy is given at the outset. Most ongoing or planned international studies tailor therapy according to the needs of the individual patient, also accounting for anatomic stage, tumor burden, age, gender, and biologic host factors that affect prognosis. With this approach it might be possible to use less aggressive treatment regimens for the lower-risk groups and limit the use of the more aggressive dose- and time-intensified/dense regimens for the higher-risk groups. With this individualized approach it might be possible to yield higher cure rates and simultaneously reduce the risk for late complications and mortality. [References: 35]

Publication Type: Journal Article. Review.
 

<2>

Unique Identifier [PMID]: 17908622

Authors: Landgren O. Caporaso NE.

Institution: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Department of Health and Human Services, National Institutes of Health, 6120 Executive Boulevard, Building EPS/Room 7110, Bethesda, MD 20892-7236, USA. landgreo@mail.nih.gov

Title: New aspects in descriptive, etiologic, and molecular epidemiology of Hodgkin's lymphoma. [Review] [107 refs]

Source: Hematology - Oncology Clinics of North America. 21(5):825-40, 2007 Oct.

Abstract: Epstein-Barr virus (EBV) has remained the main candidate suggested as the infection causing Hodgkin's lymphoma for several years. However, EBV genome has been found only within the tumor in about 20%-40% of Hodgkin's lymphoma cases with a prior diagnosis of infectious mononucleosis. Recently, autoimmune and related conditions have drawn attention to a potential role for immune-related and inflammatory conditions in the etiology and pathogenesis of the malignancy. Evidence from multiple affected families from case series, a twin study, a case-control study, and population-based registry studies implicate a role for genetic factors. Simultaneously, data from Eastern Asia and among Chinese immigrants in North America indicate increasing incidence trends for Hodgkin's lymphoma being associated with westernization. These results emphasize an interaction between environmental and genetic risk factors in Hodgkin's lymphoma. [References: 107]

Publication Type: Journal Article. Research Support, N.I.H., Intramural. Review.
 

<3>

Unique Identifier [PMID]: 17631599

Authors: Diehl V. Fuchs M.

Institution: University of Cologne, Cologne, Germany.

Title: Early, intermediate and advanced Hodgkin's lymphoma: modern treatment strategies. [Review] [20 refs]

Source: Annals of Oncology. 18 Suppl 9:ix71-9, 2007 Jul.

Publication Type: Journal Article. Review.
 

<4>

Unique Identifier [PMID]: 17503349

Authors: Fraga M. Forteza J.

Institution: Department of Pathology, Clinical and Universitary Hospital, Santiago de Compostela, Spain.

Title: Diagnosis of Hodgkin's disease: an update on histopathological and immunophenotypical features. [Review] [122 refs]

Source: Histology & Histopathology. 22(8):923-35, 2007 Aug.

Abstract: The Hodgkin lymphoma (HL) is a B-cell lymphoma, as was proved by molecular studies with single-cell PCR. Histologically, it is characterized by a minority of neoplastic cells, Reed-Sternberg cells and its variants, related to a variable non-neoplastic inflammatory background. Nowadays, (WHO classification) the following types of HL are recognized: Nodular Paragranuloma and the Classical Hodgkin Lymphoma, the latter including Nodular Sclerosis, Mixed Cellularity, Lymphocyte-rich Classical Hodgkin Lymphoma and Lymphocyte Depletion. Morphology together with immunohistochemical studies allows to classify the different forms of Hodgkin lymphoma and to make a differential diagnosis with non-Hodgkin lymphomas. All classical Hodgkin lymphomas are treated similarly, and chances for remission and survival are currently good. Molecular parameters should be added to the current classification and patients could benefit from new therapeutic targets. [References: 122]

Publication Type: Journal Article. Research Support, Non-U.S. Gov't. Review.
 

<5>

Unique Identifier [PMID]: 17474345

Authors: Hagemeister FB.

Institution: Department of Hematology, The University of Texas M.D. Anderson Cancer Center Houston, Texas 77030, USA. fhagemei@.mdanderson.org

Title: Hodgkin's lymphoma in younger patients: lessons learned on the road to success. [Review] [34 refs]

Source: Oncology (Williston Park). 21(4):434-40; discussion 441-2, 445-6, 2007 Apr.

Abstract: Despite significant improvements in the treatment of Hodgkin's lymphoma over the past 2 decades, physicians continue to face dilemmas in therapy for the disease, and many cured patients live with complications of treatment. Newer therapeutic options are still needed for the disease, to minimize complications and to improve the treatment of patients in relapse. This review considers the treatment of Hodgkin's lymphoma in younger patients, addressing such issues as which patients with early-stage disease may require radiotherapy, what prognostic factors provide information that can affect treatment choices in patients with advanced disease, and what we have learned about treatment complications in this setting. [References: 34]

Publication Type: Journal Article. Review.
 

<6>

Unique Identifier [PMID]: 17296811

Authors: Byrne BJ. Gockerman JP.

Institution: Duke University Medical Center, Box 3841, Durham, North Carolina 27710, USA. byrne005@mc.duke.edu

Title: Salvage therapy in Hodgkin's lymphoma. [Review] [69 refs]

Source: Oncologist. 12(2):156-67, 2007 Feb.

Abstract: Hodgkin's disease is a rare malignancy that affects approximately 7,500 patients per year in the U.S., leading to an estimated 1,400 deaths. The relapse rate for this disease varies from around 5% for early-stage disease to 35% for patients with advanced disease. Patients who relapse after chemotherapy have about a 20% cure rate with conventional salvage chemotherapy. Two randomized phase III studies have shown an improved failure-free survival rate with high-dose chemotherapy and autologous stem cell support compared with conventional chemotherapy in relapsed patients. They failed to show any improvement in overall survival. For patients who experience failure with autologous transplant, the options of single-agent chemotherapy with gemcitabine, vinblastine, or vinorelbine can be used for palliation. Standard myeloablative allogeneic bone marrow transplant has a high mortality rate in this population. Allogeneic transplant regimens with reduced intensity are currently being studied in clinical trials. Further studies on the use of monoclonal antibodies and radiolabeled antibodies need to be conducted to define their role in the treatment of Hodgkin's disease. [References: 69]

Publication Type: Journal Article. Review.
 

<7>

Unique Identifier [PMID]: 16529147

Authors: Ansell SM. Armitage JO.

Institution: Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. ansell.stephen@mayo.edu

Title: Management of Hodgkin lymphoma. [Review] [70 refs]

Source: Mayo Clinic Proceedings. 81(3):419-26, 2006 Mar.

Abstract: Approximately 7350 new cases of Hodgkin lymphoma (HL) are diagnosed annually in the United States. The Incidence of HL has a bimodal pattern, with the highest incidence seen in young adults and in elderly patients. The disease is composed of 2 distinct entities: the more commonly diagnosed classical HL and the rare nodular lymphocyte-predominant HL. Classical HL includes the subgroups nodular sclerosis, mixed cellularity, lymphocyte depletion, and lymphocyte rich. Selection of the appropriate therapy Is based on accurately assessing the stage of disease. Patients with early-stage disease are treated with combined modality strategies using abbreviated courses of combination chemotherapy followed by Involved-field radiation therapy, whereas those with advanced-stage disease receive a longer course of chemotherapy without radiation therapy. Currently, more than 80% of all patients with newly diagnosed HL are expected to be long-term survivors. Although many patients respond well to initial therapies and have durable long-term remissions, a subset of patients has resistant disease and experiences relapse even after subsequent high-dose chemotherapy and autologous stem cell transplantation. New therapies are clearly needed for these patients. [References: 70]

Publication Type: Journal Article. Review.
 

<8>

Unique Identifier [PMID]: 12648984

Authors: Yung L. Linch D.

Institution: Royal Free and University College Medical School, WC1E 6HX, London, UK.

Title: Hodgkin's lymphoma. [Review] [110 refs]

Source: Lancet. 361(9361):943-51, 2003 Mar 15.

Abstract: Hodgkin's lymphoma was first described in 1832, but the nature of the pathognomic Reed-Sternberg cell, on which diagnosis of the disease is based, has only been elucidated in the past few years. Radiotherapy has been used to treat localised disease since the 1940s, and in the 1960s, effective combination chemotherapy regimens were introduced for anatomically advanced disease. The past three decades have witnessed continued improvement in outcome to such an extent that Hodgkin's lymphoma is now one of the most curable of all non-cutaneous malignancies. With improved survival and extended follow-up, relevance of treatment-induced late effects has become apparent, and modern therapeutic strategies must fully account for these effects. We review the pathology of Hodgkin's lymphoma, and its clinical presentation, investigation, present management, and natural history, including late effects of treatment. [References: 110]

Publication Type: Journal Article. Research Support, Non-U.S. Gov't. Review.