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Encyclopedia > Hodgkin's lymphoma
Hodgkin's lymphoma
Classification and external resources
Lymph node biopsy showing Hodgkin's lymphoma.
ICD-10 C81.
ICD-9 201
ICD-O: 9650/3-9667/3
DiseasesDB 5973
MedlinePlus 000580
eMedicine med/1022 
MeSH D006689

Hodgkin's lymphoma, also known as Hodgkin's disease, is a type of lymphoma first described by Thomas Hodgkin in 1832. Hodgkin's lymphoma is characterized clinically by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease. Pathologically, the disease is characterized by the presence of Reed-Sternberg cells. Hodgkin's lymphoma was one of the first cancers to be cured by radiation. Later it was one of the first to be cured by combination chemotherapy. The cure rate is about 93%, making it one of the most curable forms of cancer—if it is detected in the early stages. Later-stage cancers show a significantly worse prognosis[1]. The Handbook of Cancer Chemotherapy, Sixth Edition states that "the potential for cure should not lead clinicians and patients to lose sight of the fact that [Hodgkin's lymphoma] is a malignancy and that approximately 20% to 25% of patients...die of the disease."[2] Image File history File linksMetadata Hodgkin_lymphoma_(1)_mixed_cellulary_type. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... This article is about lymphoma in humans. ... Thomas Hodgkin (August 17, 1798 - April 5, 1866) was a British physician and considered one of the most prominent pathologists of his time and a pioneer in preventive medicine. ... Lymph nodes are components of the lymphatic system. ... B symptoms are a feature of both Hodgkins lymphoma and non-Hodgkins lymphoma, and include: Fever Drenching sweats, especially at night Weight loss. ... Reed-Sternberg cells are abnormal cells found on light microscopy in biopsies from individuals with Hodgkins disease (a type of lymphoma), and certain other disorders. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... The era of cancer chemotherapy began in the 1940s with the first use of nitrogen mustards and folic acid antagonist drugs. ...

Contents

Epidemiology

Unlike some other lymphomas, whose incidence increases with age, Hodgkin's lymphoma has a bimodal incidence curve; that is, it occurs most frequently in two separate age groups, the first being young adulthood (age 15–35) and the second being in those over 55 years old although these peaks may vary slightly with nationality.[3] Overall, it is more common in males, except for the nodular sclerosis variant (see below), which is more common in females. Non-Hodgkin lymphoma (NHL) describes a group of cancers arising from lymphocytes, a type of white blood cell. ... Incidence is a measure of the risk of developing some new condition within a specified period of time. ... In statistics, a bimodal distribution is a distribution with two different peaks — that is, there are two distinct values that measurements tend to center around. ... Nodular sclerosis (or NSHD) is a form of Hodgkins disease which is most common in developed countries. ...


The annual incidence of Hodgkin's lymphoma is about one in 25,000 people, and the disease accounts for slightly less than 1% of all cancers worldwide.


The incidence of Hodgkin's lymphoma is increased in patients with HIV infection.[4] In contrast to many other lymphomas associated with HIV infection it occurs most commonly in patients with higher CD4 T cell counts.


Symptoms

Patients with Hodgkin's lymphoma may present with the following symptoms:

  • Lymph nodes: the most common symptom of Hodgkin's is the painless enlargement of one or more lymph nodes. The nodes may also feel rubbery and swollen when examined by a physician. The nodes of the neck and shoulders (cervical and supraclavicular) are most frequently involved (80-90% of the time, on average). The lymph nodes of the chest are often affected and these may be noticed on a chest radiograph.
  • Splenomegaly: enlargement of the spleen occurs in about 30% of people with Hodgkin's lymphoma. The enlargement, however, is seldom massive and the size of the spleen may fluctuate during the course of treatment.[5]
  • Hepatomegaly: enlargement of the liver, due to liver involvement, is present in about five percent of cases.
  • Hepatosplenomegaly: the enargement of both the liver and spleen caused by the same disease.
  • Pain:
    • Pain following alcohol consumption: classically, involved nodes are painful after alcohol consumption, though this phenomenon is rare[6].
    • Back pain: nonspecific back pain (pain that cannot be localized or its cause determined by examination or scanning techniques) has been reported in some cases of Hodgkin's lymphoma.
  • Systemic symptoms: about one-third (⅓) of patients with Hodgkin's disease may also present with systemic symptoms, including low-grade fever; night sweats; unexplained weight loss of at least 10% of the patient's total body mass in six months or less, itchy skin (pruritus) due to increased levels of eosinophils in the bloodstream; or fatigue (lassitude). Systemic symptoms such as fever, night sweats, and weight loss are known as B symptoms; thus, presence of fever, weight loss, and night sweats indicate that the patient's stage is, for example, 2B instead of 2A[7].
  • Cyclical fever: patients may also present with a cyclical high-grade fever known as the Pel-Ebstein fever[8], or more simply "P-E fever". However, there is debate as to whether or not the P-E fever truly exists[9].

Lymph nodes are components of the lymphatic system. ... In anatomy, cervical is an adjective that has two meanings: of or pertaining to the neck. ... The supraclavicular nerves (descending branches) arise from the third and fourth cervical nerves; they emerge beneath the posterior border of the Sternocleidomastoideus, and descend in the posterior triangle of the neck beneath the platysma and deep cervical fascia. ... Image A: A normal chest X-ray. ... Splenomegaly is an enlargement of the spleen, which usually lies in the left upper quadrant (LUQ) of the human abdomen. ... The spleen is an organ located in the abdomen, where it functions in the destruction of old red blood cells and holding a reservoir of blood. ... Hepatomegaly is the condition of having an enlarged liver. ... The liver is the largest internal organ in the human body, and is an organ present in vertebrates and some other animals. ... Hepatosplenomegaly is the simultaneous enlargement of both the liver (hepatomegaly) and the spleen (splenomegaly). ... Look up Pain in Wiktionary, the free dictionary. ... Back pain (also known dorsalgia) is pain felt in the back that may originate from the muscles, nerves, bones, joints or other structures in the spine. ... An analogue medical thermometer showing the temperature of 38. ... Night sweats may be a symptom of: Tuberculosis HIV Hodgkins disease Brucellosis Subacute endocarditis Chronic pneumonia Pulmonary histoplasmosis See also Sleep Hyperhydrosis Sign (medicine) Categories: Stub ... For other uses, see Itch (disambiguation). ... Eosinophil granulocyte Eosinophil granulocytes, commonly referred to as eosinophils (or less commonly as acidophils), are white blood cells that are responsible for combating infection by parasites in the body. ... The word fatigue is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... B symptoms are a feature of both Hodgkins lymphoma and non-Hodgkins lymphoma, and include: Fever Drenching sweats, especially at night Weight loss. ... Pel-Ebstein fever is a rarely seen condition noted in patients with Hodgkins lymphoma in which the patient experiences fevers which cyclicly increase then decrease over an average period of 1 or two weeks. ...

Diagnosis

Hodgkin's lymphoma must be distinguished from non-cancerous causes of lymph node swelling (such as various infections) and from other types of cancer. Definitive diagnosis is by lymph node biopsy (Usually excisional biopsy with microscopic examination). Blood tests are also performed to assess function of major organs and to assess safety for chemotherapy. Positron emission tomography (PET) is used to detect small deposits that do not show on CT scanning. In some cases a Gallium Scan may be used instead of a PET scan. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer. ... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three-dimensional image or map of functional processes in the body. ... In medicine, gallium imaging is a radiopharmaceutical method to detect infections and cancer. ...


Pathology

Macroscopy

Affected lymph nodes (most often, laterocervical lymph nodes) are enlarged, but their shape is preserved because the capsule is not invaded. Usually, the cut surface is white-grey and uniform; in some histological subtypes (e.g. nodular sclerosis) a nodular aspect may appear. Nodular sclerosis (or NSHD) is a form of Hodgkins disease which is most common in developed countries. ...


Microscopy

Microscopic examination of the lymph node biopsy reveals complete or partial effacement of the lymph node architecture by scattered large malignant cells known as Reed-Sternberg cells (typical and variants) admixed within a reactive cell infiltrate composed of variable proportions of lymphocytes, histiocytes, eosinophils, and plasma cells. The Reed-Sternberg cells are identified as large often bi-nucleated cells with prominent nucleoli and an unusual CD45-, CD30+, CD15+/- immunophenotype. In approximately 50% of cases, the Reed-Sternberg cells are infected by the Epstein-Barr virus. In immunology, the CD45 antigen (CD stands for cluster of differentiation) is a protein which is a leucocyte common antigen, a type I transmembrane protein present on all differentiated hematopoietic cells except erythrocytes that assists in the activation of those cells (a form of co-stimulation). ... Cluster of differentiation (CD) molecules are markers on the cell surface, as recognized by specific sets of antibodies, used to identify the cell type, stage of differentiation and activity of a cell. ... CD15 (3-fucosyl-N-acetyl-lactosamine) is a cluster of differentiation - an immunologically significant molecule. ... The Epstein-Barr virus (EBV), also called Human herpesvirus 4 (HHV-4), is a virus of the herpes family (which includes Herpes simplex virus and Cytomegalovirus), and one of the most common viruses in humans. ... This article is about biological infectious particles. ...


Characteristics of classic Reed-Sternberg cells include large size (20–50 micrometres), abundant, amphophilic, finely granular/homogeneous cytoplasm; two mirror-image nuclei (owl eyes) each with an eosinophilic nucleolus and a thick nuclear membrane (chromatin is distributed at the cell periphery). Chromatin is the complex of DNA and protein found inside the nuclei of eukaryotic cells. ...


Variants:

  • Hodgkin's cell (atypical mononuclear RSC) is a variant of RS cell, which has the same characteristics, but is mononucleated.
  • Lacunar RSC is large, with a single hyperlobated nucleus, multiple, small nucleoli and eosinophilic cytoplasm which is retracted around the nucleus, creating an empty space ("lacunae").
  • Pleomorphic RSC has multiple irregular nuclei.
  • "Popcorn" RSC (lympho-histiocytic variant) is a small cell, with a very lobulated nucleus, small nucleoli.
  • "Mummy" RSC has a compact nucleus, no nucleolus and basophilic cytoplasm. [10]

Hodgkin's lymphoma can be sub-classified by histological type. The cell histology in Hodgkin's lymphoma is not as important as it is in non-Hodgkin's lymphoma: the treatment and prognosis in Hodgkin's lymphoma depend on the stage of disease rather than the histotype. Non-Hodgkins lymphoma is a type of cancer. ...


Types

Classical Hodgkin's lymphoma (excluding nodular lymphocyte predominant Hodgkin's) can be subclassified into 4 pathologic subtypes based upon Reed-Sternberg cell morphology and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen. (M9650/3) The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ...

Family Name Description ICD-10 ICD-O
Classical Nodular sclerosing CHL Is the most common subtype and is composed of large tumor nodules with lacunar RS cells subtype composed of numerous classic often pleomorphic RS cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma. C81.1 M9663/3
Classical Mixed-cellularity subtype Is a common subtype and is composed of numerous classic RS cells admixed with numerous inflammatory cells including lymphocytes, histiocytes, eosinophils, and plasma cells. C81.2 M9652/3
Classical Lymphocyte-rich Is a rare subtype. C81.0 M9651/3
Classical Lymphocyte depleted Is a rare subtype. C81.3 M9653/3
Non-classical Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL) Is no longer classified as a form of classic Hodgkin's lymphoma. This is due to the fact that the RSC variants (popcorn cells) that characterize this form of the disease invariably express B lymphocyte markers such as CD20 (thus making NLPHL an unusual form of B cell lymphoma), and that (unlike classic HL) NLPHL may progress to diffuse large B cell lymphoma. There are small but clear differences in prognosis between the various forms. Lymphocyte predominant HL is an uncommon subtype composed of vague nodules of numerous reactive lymphocytes admixed with large popcorn-shaped RSC. Unlike classic RSC, the non-classic popcorn-shaped RS cells of NLPHL are CD15 and CD30 negative while positive for the B cell marker CD20. C81.7 M9659/3

The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) is a detailed description of known diseases and injuries. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... For malignant tumors specifically, see cancer. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... A scanning electron microscope (SEM) image of a single human lymphocyte. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... B-cell lymphoma is a type of non-Hodgkin lymphoma affecting B cells. ... CD15 (3-fucosyl-N-acetyl-lactosamine) is a cluster of differentiation - an immunologically significant molecule. ... Cluster of differentiation (CD) molecules are markers on the cell surface, as recognized by specific sets of antibodies, used to identify the cell type, stage of differentiation and activity of a cell. ... CD20 is a non-glycosylated phosphoprotein expressed on the surface of all mature B-cells. ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ...

Staging

After Hodgkin's lymphoma is diagnosed, a patient will be staged: that is, they will undergo a series of tests and procedures which will determine what areas of the body are affected. These procedures will include documentation of their histology, a physical examination, blood tests, chest X-ray radiographs, computed tomography (CT) scans or magnetic resonance imaging (MRI) scans of the chest, abdomen and pelvis, and a bone marrow biopsy. Positron emission tomography (PET) scan is now used instead of the gallium scan for staging. In the past, a lymphangiogram or surgical laparotomy (which involves opening the abdominal cavity and visually inspecting for tumors) were performed. Lymphangiograms or laparotomies are very rarely performed, having been supplanted by improvements in imaging with the CT scan and PET scan The stage of a cancer is a descriptor (usually numbers I to IV) of how much the cancer has spread. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... negron305 Cat scan redirects here. ... MRI redirects here. ... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three-dimensional image or map of functional processes in the body. ... Also know as Galium 67 scan, a gallium scan is a nuclear medicine test that uses a radioactive tracer to obtain images of a specific type of tissue. ... A lymphangiogram is a medical test, whereby pictures of the lymphatic system taken with X-rays after a special dye is injected to outline the lymph nodes and blood vessels. ... A laparotomy is a surgical maneuver involving an incision through the abdominal wall to gain access into the abdominal cavity. ...


On the basis of this staging, the patient will be classified according to a staging classification (the Ann Arbor staging classification scheme is a common one): Ann Arbor staging is the staging system for lymphomas, both in Hodgkins disease and non-Hodgkins lymphoma. ...

  • Stage I is involvement of a single lymph node region (I) or single extralymphatic site (Ie);
  • Stage II is involvement of two or more lymph node regions on the same side of the diaphragm (II) or of one lymph node region and a contiguous extralymphatic site (IIe);
  • Stage III is involvement of lymph node regions on both sides of the diaphragm, which may include the spleen (IIIs) and/or limited contiguous extralymphatic organ or site (IIIe, IIIes);
  • Stage IV is disseminated involvement of one or more extralymphatic organs.

The absence of systemic symptoms is signified by adding 'A' to the stage; the presence of systemic symptoms is signified by adding 'B' to the stage. In the anatomy of mammals, the diaphragm is a shelf of muscle extending across the bottom of the ribcage. ... The spleen is an organ located in the abdomen, where it functions in the destruction of old red blood cells and holding a reservoir of blood. ...


Prognosis

In 1998, an international effort[11] identified seven prognostic factors that accurately predict the success rate of conventional treatment in patients with locally extensive or advanced stage Hodgkin's lymphoma. Freedom from progression (FFP) at 5 years was directly related to the number of factors present in a patient. The 5-year FFP for patients with zero factors is 84%. Each additional factor lowers the 5-year FFP rate by 7%, such that the 5-year FFP for a patient with 5 or more factors is 42%.


The adverse prognostic factors identified in the international study are:

  • Age >= 45 years
  • Stage IV disease
  • Hemoglobin < 10.5 g/dl
  • Lymphocyte count < 600/µl or < 8%
  • Male
  • Albumin < 4.0 g/dl
  • White blood count >= 15,000/µl

Other studies have reported the following to be the most important adverse prognostic factors: mixed-cellularity or lymphocyte-depleted histologies, male sex, large number of involved nodal sites, advanced stage, age of 40 years or more, the presence of B symptoms, high erythrocyte sedimentation rate, and bulky disease (widening of the mediastinum by more than one third, or the presence of a nodal mass measuring more than 10 cm in any dimension.) The erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ... FIG. 967– Transverse section through the upper margin of the second thoracic vertebra The mediastinum is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. ...


Treatment

See also: ABVD

Patients with early stage disease (IA or IIA) are effectively treated with radiation therapy or chemotherapy. The choice of treatment depends on the age, sex, bulk and the histological subtype of the disease. Patients with later disease (III, IVA, or IVB) are treated with combination chemotherapy alone. Patients of any stage with a large mass in the chest are usually treated with combined chemotherapy and radiation therapy. ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma. ... Varian Clinac 2100C Linear Accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...


Currently, the ABVD chemotherapy regimen is the gold standard for treatment of Hodgkin's disease. The abbreviation stands for the four drugs Adriamycin, bleomycin, vinblastine, and dacarbazine. Developed in Italy in the 1970s, the ABVD treatment typically takes between six and eight months, although longer treatments may be required. Another form of treatment is the newer Stanford V regimen, which is typically only half as long as the ABVD but which involves a more intensive chemotherapy schedule and incorporates radiation therapy. However, in a randomized controlled study, Stanford V was inferior.[12] ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma. ... Chemotherapy regimens are often identified with acronyms, identifying the agents used in combination. ... Doxorubicin or adriamycin is a DNA-interacting drug widely used in chemotherapy. ... Bleomycin is an anti-cancer agent. ... Vinblastine stick molecular model Vinblastine is an anti-mitotic drug used to treat certain kinds of cancer, including Hodgkins lymphoma, non-small cell lung cancer, breast cancer and testicular cancer. ... Dacarbazine (da-KAR-ba-zeen) (brand names DTIC, DTIC-Dome; also known as DIC or Imidazole Carboxamide) is an antineoplastic chemotherapy drug used in the treatment of various cancers, among them malignant melanoma (a form of skin cancer which can spread to other parts of the body). ... Stanford V is a chemotherapy regimen designed for Hodgkins lymphoma that consists of the following: Mechlorethamine Doxorubicin Vinblastine Vincristine Bleomycin Etoposide Prednisone It is a newer method than MOPP or ABVD, the two previous most common treatments for Hodgkins lymphoma. ...


Another form of treatment, mainly in Europe for stages > II is BEACOPP. The cure rate with the BEACOPP esc. regimen is approximately 10-15% higher than with standard ABVD in advanced stages. Although this was shown in a landmark paper in The New England Journal of Medicine (Diehl et al.), the US physicians still favor ABVD. Probably because some physicians think that BEACOPP induces more secondary leukemia. However, this seems negligible compared to the higher cure rates. Also, BEACOPP is more expensive because of the G-CSF-support that is required. Currently, the German Hodgkin Study group tests 8x BEACOPP esc vs. 6x BEACOPP esc vs. 8x BEACOPP-14 baseline (HD15-trial). BEACOPP is a chemotherapy regimen for treatment of Hodgkins lymphoma in Stages > II. Patients typically receive treatment in cycles of 21 days with no drugs given on days 16-21. ...


The high cure rates and long survival of many patients with Hodgkin's lymphoma has led to a high concern with late adverse effects of treatment, including cardiovascular disease and second malignancies such as acute leukemias, lymphomas, and solid tumors within the radiation therapy field. Most patients with early stage disease are now treated with abbreviated chemotherapy and involved-field radiation therapy rather than with radiation therapy alone. Clinical research strategies are exploring reduction of the duration of chemotherapy and dose and volume of radiation therapy in an attempt to reduce late morbidity and mortality of treatment while maintaining high cure rates. Hospitals are also treating those who respond quickly to chemo-therapy with no radiation. Leukemia or leukaemia (Greek leukos λευκός, white; aima αίμα, blood) is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation (production by multiplication) of blood cells, usually white blood cells (leukocytes). ...


Notable cases

  • Luke Menard, American Idol Season 7 contestant. Diagnosed with Hodgkin's lymphoma in 2008.
  • Mark Fields Former NFL player forced to retire in 2004 from the disease.
  • Paul Allen, Microsoft co-founder, was diagnosed and treated for Hodgkin's lymphoma in 1983.
  • The actor Richard Harris died of Hodgkin's lymphoma in 2002 after filming Harry Potter and the Chamber of Secrets as main character Albus Dumbledore.
  • Former NHL star Mario Lemieux was diagnosed with Hodgkin's lymphoma in January 1993. Even after taking 2 months off, Lemieux ended up winning the scoring title that year.
  • Lynden David Hall died of Hodgkin's lymphoma in 2006.
  • Barry Watson, an actor who gained fame in the television series 7th Heaven, had successfully treated Hodgkin's lymphoma.
  • Delta Goodrem, Australian singer, was diagnosed with Hodgkin's lymphoma in July 2003.
  • Former head of NBC Entertainment, Brandon Tartikoff, died in 1997 after a 25 year battle with Hodgkin's disease.
  • Senator Arlen Specter (R-PA) was diagnosed with Phase IVB Hodgkin's Disease in 2005, underwent 5 months of chemotherapy, and received a clean bill of health. On April 15, 2008, he announced that his Hodgkin's had returned.
  • British actor Roger Tonge who played the disabled Sandy Richardson in the cult British soap opera Crossroads in the 1960s and 1970s died of Hodgkin's Disease in 1981 at the age of 35.
  • Alese Coco one of the most notable non-celebrities to have Hodgkin’s lymphoma. Known worldwide to the Hodgkin’s community as a torch bearer for Hodgkin’s research. Died at the age of 23.
  • WWE wrestler Rowdy Roddy Piper was announced to have been diagnosed with Hodgkin's lymphoma on November 27, 2006.
  • John Millington Synge, the Irish author best known for the play The Playboy of the Western World, died in 1909 from the disease.
  • Dinu Lipatti, the Romanian pianist, died of Hodgkin's disease in 1950, 33 years old.
  • Wayne Shelford, aka 'Buck' Shelford, former All Black rugby player for New Zealand.
  • Elizabeth Madox Roberts, a noted Kentucky poet and novelist, died from Hodgkin's in 1941.
  • Joy Hester, a noted Australian artist, died from Hodgkin's in 1960.
  • Emma Lazarus, Jewish American poetess, writer of the New Colossus, died of Hodgkin's disease on 19 November 1887.
  • "Mutt" Mantle, Mickey Mantle's dad, died from Hodgkins. Mickey's son Billy also had the disease.
  • Martin Fry, vocalist with ABC, was treated for Hodgkin's Disease in 1985/86.
  • James Whitham, motorcycle racer, was treated for Hodgkin's Disease in 1995/96.
  • Glen Goins, singer and guitarist for Parliament Funkadelic died from Hodgkin's Disease in 1978.
  • Alexander Litvinov, a Russian rock poet and musician, died from Hodgkin's Disease in 1999.
  • Jamie Tape AFL Footballer
  • Freida Riley, an American schoolteacher who inspired the Rocket Boys, died of Hodgkin's Disease in 1969 at the age of 31. The movie October Sky was made in honor of her and the Rocket boys.
  • Roger Patterson (not the guitarist) who had filmed the famous Patterson-Gimlin film which shows a "female" "Bigfoot" died of the disease still saying the aformentioned film was not a hoax
  • Jane Austen, one of the most famous authors of English literature, died in 1817 aged 41. The cause of death was officially recorded as Addison's disease; however, modern speculation has suggested that it may have been Hodgkin's disease.[13]

Mark Fields (born November 9, 1972 in Los Angeles, California) is an American football player who currently plays linebacker for the Carolina Panthers of the NFL. In 2003 he battled Hodgkins disease and did not play during the Panthers Super Bowl run. ... NFL logo For other uses of the abbreviation NFL, see NFL (disambiguation). ... For other persons named Paul Allen, see Paul Allen (disambiguation). ... For other persons named Richard Harris, see Richard Harris (disambiguation). ... HP2 redirects here. ... Albus Percival Wulfric Brian Dumbledore is a fictional character within the Harry Potter series written by British author J. K. Rowling. ... NHL can also be an abbreviation for National Historic Landmark or Non-Hodgkins lymphoma. ... Mario Lemieux (born October 5, 1965) is a retired professional ice hockey centre who played 17 seasons for the Pittsburgh Penguins of the National Hockey League (NHL) between 1984 and 2005. ... The Art Ross Trophy on display at the 2006 NHL Entry Draft. ... In Between Jobs (2005), album cover Lynden David Hall (May 7, 1974 – February 14, 2006) was a singer, songwriter, arranger, and producer. ... For other persons of the same name, see Barry Watson. ... This article is about the TV program. ... Delta Lea Goodrem (born 9 November 1984) is a multi ARIA Award winning Australian singer-songwriter, pianist and Logie Award winning actress. ... This article is about the television network. ... Brandon Tartikoff (January 13, 1949 — August 27, 1997) was a popular NBC executive who was credited with turning around NBCs low prime time reputation with such hit series as Hill Street Blues, L.A. Law, ALF, Family Ties, The Cosby Show, Cheers, Miami Vice, The Golden Girls, Knight Rider... Arlen J. Specter (born February 12, 1930) is a United States Senator from Pennsylvania. ... is the 105th day of the year (106th in leap years) in the Gregorian calendar. ... 2008 (MMVIII) is the current year, a leap year that started on Tuesday of the Anno Domini (or common era), in accordance with the Gregorian calendar. ... Roger Tonge (30 January 1946 - 26 February 1981) was a British actor. ... Crossroads is a British television soap opera set in a motel near Birmingham, England. ... World Wrestling Entertainment, or WWE, is a professional wrestling promotion, currently the largest in North America. ... Roderick George Toombs (born on April 17, 1954 in Saskatoon, Saskatchewan), best known by his stage name of Rowdy Roddy Piper, is a Canadian professional wrestler of Scottish descent. ... is the 331st day of the year (332nd in leap years) in the Gregorian calendar. ... Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... Edmund John Millington Synge (IPA: ) (April 16, 1871 – March 24, 1909) was an Irish dramatist, poet, prose writer, and collector of folklore. ... Dinu Lipatti (March 19, 1917, Bucharest – December 2, 1950, Geneva) was a Romanian classical pianist and composer whose career was tragically cut short by his death from Hodgkins disease at age 33. ... Wayne Buck Shelford (born 13 December 1957 in Rotorua) was a New Zealand rugby player who captained the All Blacks from 1987 to 1990. ... Elizabeth Madox Roberts Elizabeth Madox Roberts (October 30, 1881 - March 13, 1941) was a Kentucky novelist and poet, primarily known for her novels and stories about the Kentucky mountain people, including The Time of Man (1926), The Great Meadow (1930) and A Buried Treasure (1931). ... Joy Hester (1920-1960) was an Australian artist who lived a tumultuous, uncompromising and tragic life. ... Emma Lazarus (July 22, 1849 – November 19, 1887) was an American poet born in New York City. ... is the 323rd day of the year (324th in leap years) in the Gregorian calendar. ... Year 1887 (MDCCCLXXXVII) was a common year starting on Saturday (link will display the full calendar) of the Gregorian calendar (or a common year starting on Thursday of the 12-day slower Julian calendar). ... Martin Fry (born 9 March 1958, in Manchester) is the lead singer of the band ABC. Just The Two Of Us Martin Fry appeared in the BBC Television programme Just The Two Of Us in February 2006. ... ABC is an English New Romantic band that charted eleven Top 40 singles between 1981 and 1990. ... James Jamie Whitham (born September 6, 1966 in Huddersfield, Yorkshire, England), is a former professional motorcycle road racer. ... Glen Goins was an incredibly talented singer and musician from the Parliament Funkadelic Funk Mob in the 1970s. ... George Clinton and Parliament-Funkadelic performing at the Granada Theater in Dallas, Texas, May 4, 2006. ... Frame 352 from the film, allegedly capturing a bigfoot mid-stride. ... // Sexual slang is any slang term which makes reference to sex, the sexual organs, or matters closely related to them. ... It has been suggested that Evidence regarding Bigfoot be merged into this article or section. ... A watercolour and pencil sketch of Jane Austen, believed to be drawn from life by her sister Cassandra (c. ... Addisons disease(also known as chronic adrenal insufficiency, hypocortisolism or hypocorticism) is a rare endocrine disorder in which the adrenal gland produces insufficient amounts of steroid hormones (glucocorticoids and often mineralocorticoids). ...

Cultural references

  • A main character in the movie October Sky (and the book Rocket Boys), Miss Riley, was diagnosed with Hodgkin's lymphoma.
  • In the novel Don't Die, My Love, by Lurlene McDaniel, one of the main characters, Luke, is diagnosed with Hodgkin's and dies after about a year and a half.
  • In the latter part of the television series Party of Five, Charlie Salinger (played by Matthew Fox), was diagnosed with Hodgkin's and, through rigorous regimens and treatments, went into remission.
  • In Desperate Housewives, the character of Lynette Scavo, (played by Felicity Huffman) is diagnosed with Hodgkin's lymphoma, which she tries to keep a secret.
  • Bang the Drum Slowly by Mark Harris is a novel about a baseball player's last season when only he and his best friend know he is dying of Hodgkin's disease. It was later made into a film of the same name.
  • In the television show Curb your Enthusiasm episode "The Five Wood" Larry David believes his friend's father suffered from "the good hodgkin's," and that he learned about it from an episode of Party of Five.
  • In Jeffrey Archer's "Kane and Abel", Matthew Lester is diagnosed with Hodgkin's, but does not disclose his discovery to anyone. His best friend, William Kane, is told by Doctor MacKenzie abut the illness shortly before Matthew's death.
  • In the 1996 film Infinity (with Matthew Broderick and Patricia Arquette), Arline Greenbaum (Arquette) is suspected of having Hodgkin's lymphoma. It later turns out to be lymphatic tuberculosis.
  • Constable Deirdre 'Dash' McKinley in Australian Police Drama Blue Heelers was diagnosed with Hodgkins and shaved her head to save herself the trauma of going through hair loss.
  • Actor DJ Qualls diagnosed with Hodgkin's lymphoma at 14, declared to be in remission after 2 years of treatment at 16

October Sky is a 1999 movie based on the book Rocket Boys, an autobiographical book by Homer Hickam. ... Rocket Boys AKA October Sky is the first memoir in a series of three, by Homer Hickam, Jr. ... Freida J. Riley (1937 – August 5, 1969) was an American science and math teacher who taught at Big Creek High School in War, West Virginia while suffering from Hodgkins Disease. ... Lurlene McDaniel (born c. ... Party of Five is an American dramatic television series that premiered on FOX Network, September 12, 1994 and ended on May 3, 2000 after six seasons. ... Matthew Fox may be: Matthew Fox (movie tycoon) heir to the Fox motion pictures fortune; married Yolande Betbeze, Miss America 1951 Matthew Fox (priest) (born 1940) Catholic & Episcopal priest and author Matthew Fox (actor) (born 1966) American actor Category: ... Desperate Housewives is an American television comedy-drama series, created by Marc Cherry, who also serves as show runner, and produced by ABC Studios and Cherry Productions. ... Lynette Scavo (née Lindquist) (born April, 1963) is a fictional character on the ABC television series Desperate Housewives. ... Felicity Huffman (born December 9, 1962) is an Academy Award-nominated and Emmy Award-winning American film and television actress. ... Bang the Drum Slowly was Mark Harriss most celebrated baseball novel, a sequel to The Southpaw (1953). ... Mark Harris (November 19, 1922 in Mount Vernon, New York– May 30, 2007) was an American novelist, literary biographer, and educator. ... Bang the Drum Slowly is a 1973 film adaption of the 1956 baseball novel of the same name by Mark Harris. ... Curb Your Enthusiasm is an American sitcom starring Seinfeld writer, co-creator, and executive producer Larry David as himself. ... Not to be confused with Geoffrey Archer or Baron Archer of Sandwell. ... For other uses, see Infinity (disambiguation). ... Matthew Broderick (born March 21, 1962) is a Tony Award-winning American film and stage actor who is best known for his roles as the title character in Ferris Buellers Day Off and the adult Simba in Disneys The Lion King. ... Patricia T. Arquette (born April 8, 1968) is an Emmy Award-winning and Golden Globe Award-nominated American actress. ... Dash McKinley was a fictional character from Blue Heelers. ... This article is about the Australian television programme. ... Donald Joseph “DJ” Qualls (born June 10, 1978) is an American fashion model and actor. ...

See also

ABVD is a chemotherapy regimen used in the first-line treatment of Hodgkin lymphoma. ... Stanford V is a chemotherapy regimen designed for Hodgkins lymphoma that consists of the following: Mechlorethamine Doxorubicin Vinblastine Vincristine Bleomycin Etoposide Prednisone It is a newer method than MOPP or ABVD, the two previous most common treatments for Hodgkins lymphoma. ... Non-Hodgkin lymphoma (NHL) describes a group of cancers arising from lymphocytes, a type of white blood cell. ...

References

  1. ^ Stein, RS.; Morgan, D (2003). Handbook of Cancer Chemotherapy, Sixth Edition. Lippincott Williams & Wilkins, 493, Table 21.2: "Hodgkin's Disease: Incidence of stages and results of therapy." ISBN 0-7817-3629-3.
  2. ^ Ibid., 489. ISBN 0-7817-3629-3.
  3. ^ Mauch, Peter; James Armitage, Volker Diehl, Richard Hoppe, Laurence Weiss (1999). Hodgkin's Disease. Lippincott Williams & Wilkins, 62-64. ISBN 0-7817-1502-4. 
  4. ^ Biggar RJ, Jaffe ES, Goedert JJ, Chaturvedi A, Pfeiffer R, Engels EA (2006). "Hodgkin lymphoma and immunodeficiency in persons with HIV/AIDS". Blood 108 (12): 3786-91. doi:10.1182/blood-2006-05-024109. PMID 16917006. 
  5. ^ Howard Terebelo, DO, FACP: discussion with patient, July 5, 2007.
  6. ^ [Anonymous]. Symptoms & Signs. The Lymphomas. 2006: 11.
  7. ^ Ibid., 13,14.
  8. ^ RK Gupta, MB, PhD, FRCP; MK Gospodarowicz, MD, FRCPC; T. Andrew Lister, MD. Clinical Evaluation and Staging of Hodgkin's Disease. Hodgkin's Disease: 1999; 230-1. ISBN 0-7187-150204
  9. ^ Asher, Richard (July 6, 1995). "Making Sense". The New England Journal of Medicine 333. 
  10. ^ Reed-Sternberg cell - Hodgkin lymphoma
  11. ^ Hasenclever D, Diehl V (1998-11-19). "A Prognostic Score for Advanced Hodgkin's Disease". New England Journal of Medicine 339 (21): 1506-14. doi:10.1056/NEJM199811193392104. PMID 9819449. 
  12. ^ Gobbi PG, Levis A, Chisesi T, et al (2005). "ABVD versus modified stanford V versus MOPPEBVCAD with optional and limited radiotherapy in intermediate- and advanced-stage Hodgkin's lymphoma: final results of a multicenter randomized trial by the Intergruppo Italiano Linfomi". J. Clin. Oncol. 23 (36): 9198-207. doi:10.1200/JCO.2005.02.907. PMID 16172458. 
  13. ^ Upfal A (2005). "Jane Austen’s lifelong health problems and final illness: New evidence points to a fatal Hodgkin’s disease and excludes the widely accepted Addison's". J Med Ethics Med Humanities 31: 3-11. 

Lippincott Williams & Wilkins is an academic & professional medical publisher, founded in 1792 and now part of the Wolters Kluwer group. ... Lippincott Williams & Wilkins is an academic & professional medical publisher, founded in 1792 and now part of the Wolters Kluwer group. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... is the 187th day of the year (188th in leap years) in the Gregorian calendar. ... Year 1995 (MCMXCV) was a common year starting on Sunday. ... Year 1998 (MCMXCVIII) was a common year starting on Thursday (link will display full 1998 Gregorian calendar). ... is the 323rd day of the year (324th in leap years) in the Gregorian calendar. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ... A digital object identifier (or DOI) is a standard for persistently identifying a piece of intellectual property on a digital network and associating it with related data, the metadata, in a structured extensible way. ...

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National charities
The National Cancer Institute (NCI) is part of the United States Federal governments National Institutes of Health. ... Sydney Childrens Hospital is a hospital for children in the Eastern Suburbs of Sydney, New South Wales. ... The Merck Manual of Diagnosis and Therapy (often referred to simply as The Merck Manual) is one of the worlds most widely used medical textbooks. ...

// Aggressive NK-cell leukemia/lymphoma, large granular lymphocyte leukemia, NK-cell type[1] 9948/3[1] Aggressive NK-cell leukemia is a disease with an aggressive, systemic proliferation of natural killer cells (NK cells) and a rapidly declining clinical course. ... Post-transplant lymphoproliferative disorder (PTLD) is the name given to a group of B cell lymphomas occurring in immunosuppressed patients following organ transplant. ... Myeloid cells is a subsummating term for all hemopoietic cells except the lymphoid ones (T-cells, B-cells, NK-cells, dendritic cells). ... Myeloid leukaemia can refer to: Acute myelogenous leukemia Chronic myelogenous leukemia Category: Disambiguation ... Acute myeloid leukemia (AML), also known as acute myelogenous leukemia, is a cancer of the myeloid line of white blood cells, characterized by the rapid proliferation of abnormal cells which accumulate in the bone marrow and interfere with the production of normal blood cells. ... Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of white blood cells. ... Acute monocytic leukemia (AMoL, or AML-M5) is considered a type of acute myeloid leukemia. ... Erythroleukemia (or acute Di Guglielmo syndrome) is a rare form of acute myeloid leukemia where the myeloproliferation is of erythrocyte precursors. ... Chronic myelogenous leukemia (CML) is a form of chronic leukemia characterized by increased and unregulated clonal production of predominantly myeloid cells in the bone marrow. ... Chronic monocytic leukemia (CMoL) is a type of chronic myeloid leukemia characterized by a dominance of monocytes in the marrow. ... Philadelphia chromosome or Philadelphia translocation is a specific genetic, chromosomal abnormality that is associated with chronic myelogenous leukemia (CML) and involves an exchange of material between chromosomes 9 and 22. ... A chloroma, or granulocytic sarcoma, or most appropriately, extramedullary myeloid tumor, is a solid tumor composed of immature malignant white blood cells called myeloblasts. ... The myelodysplastic syndromes (MDS, formerly known as preleukemia) are a diverse collection of hematological conditions united by ineffective production of blood cells and varying risks of transformation to acute myelogenous leukemia. ... The myeloproliferative diseases (MPDs) are a group of diseases of the bone marrow in which excess cells are produced. ... Primary polycythemia, often called polycythemia vera (PCV), polycythemia rubra vera (PRV), or erythremia, occurs when excess red blood cells are produced as a result of an abnormality of the bone marrow. ... Essential thrombocytosis (ET, also known as essential thrombocythemia) is a rare chronic blood disorder characterized by the overproduction of platelets by megakaryocytes in the bone marrow in the absence of an alternative cause. ... Myelofibrosis with myeloid metaplasia, also known as agnogenic myeloid metaplasia, chronic idiopathic myelofibrosis, and primary myelofibrosis,[1] was first described in 1879 and is currently classified as a myeloproliferative disease caused by the growth and proliferation of an abnormal bone marrow stem cell, resulting in the replacement of the bone... Chronic neutrophilic leukemia (CNL) is a rare myeloproliferative disorder that features a persistent neutrophilia in peripheral blood, myeloid hyperplasia in bone marrow, hepatosplenomegaly, and the absence of the Philadelphia chromosome or a BCR/ABL fusion gene. ... The hypereosinophilic syndrome is a disease process characterized by a persistently elevated eosinophil count (≥ 1500 eosinophils/mm³) in the blood for at least six months without any recognizable cause after a careful workup, with evidence of involvement of either the heart, nervous system, or bone marrow. ... The myelodysplastic syndromes (MDS, formerly known as preleukemia) are a diverse collection of hematological conditions united by ineffective production of blood cells and varying risks of transformation to acute myelogenous leukemia. ... Sideroblastic anemia is caused by the abnormal production of red blood cells as part of myelodysplastic syndrome, which can evolve into hematological malignancies (especially acute myelogenous leukemia). ... Paroxysmal nocturnal hemoglobinuria (PNH) is a rare acquired life-threatening disease of the blood characterised by hemolytic anemia, thrombosis and red urine due to breakdown of red blood cells. ... A mast cell tumor is a type of tumor consisting of mast cells that is found in many species of animals. ... Mast-cell sarcoma is an aggressive[1] form of sarcoma of the mast cells. ... In medicine, mastocytosis is a group of rare disorders of both children and adults caused by the presence of too many mast cells (mastocytes) in a persons body. ... Malignant histiocytosis is a hereditary disease found in the Bernese Mountain Dog characterized by histiocytic infiltration of the lungs and lymph nodes. ... This article or section is in need of attention from an expert on the subject. ...


  Results from FactBites:
 
Non-Hodgkin's Lymphoma - oncologychannel (959 words)
Lymphomas are cancers of the lymphatic system - the body's blood-filtering tissues that help to fight infection and disease.
Unlike Hodgkins disease, NHL is comprised of approximately 10 different subtypes (in the Working Formulation) and 20 different disease entities in the Revised European-American Lymphoma Classification (REAL) system.
Therapy is determined by several factors, including the biologic state of the lymphoma, the stage of lymphoma, the presence or absence of symptoms (e.g., weight loss, night sweats, organ dysfunction), and the overall general health of the patient.
Lymphoma Information Network - Adult Hodgkin's Disease (512 words)
Hodgkin's Lymphoma or Hodgkin's Disease (two terms for the same thing) is a malignant (cancerous) growth of cells in the lymph system.
Hodgkin's Disease is the better known form of lymphoma (the other lymphomas are grouped into what is called the Non-Hodgkin's Lymphomas).
The incidence or number of cases of Hodgkin's lymphoma (about 7880 cases, 4330 men and 3550 women in the United States this year) is significant although less than the number of cases of Non-Hodgkin's lymphoma (over 53,000 in the US this year).
  More results at FactBites »

 
 

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