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Approach to Hodgkin's lymphoma in the new millennium
Author(s) -
Fung Henry C.,
Nademanee Auayporn P.
Publication year - 2002
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.683
Subject(s) - medicine , abvd , lymphoma , autologous stem cell transplantation , disease , radiation therapy , surgery , oncology , stage (stratigraphy) , transplantation , chemotherapy , cyclophosphamide , vincristine , paleontology , biology
Approximately 75% of patients with Hodgkin's lymphoma can be cured with modern chemotherapy and radiation. Most patients are treated according to clinical stage and the associated prognostic factors. For patients with limited stage Hodgkin's lymphoma, combined modality treatment has replaced subtotal nodal irradiation as the preferred treatment option. This approach eliminates laparotomy and potentially decreases the long‐term toxicity secondary to extended field irradiation and splenectomy. Furthermore, recent studies suggest that it may improve disease control and possibly survival. Multiple novel regimens have been tested in the past 20 years in patients with advanced Hodgkin's lymphoma including dose‐intense regimens, but current evidence suggests that ABVD remains the treatment of choice outside clinical trials. Over the past decade, the treatment‐related morbidity and mortality associated with autologous stem cell transplantation have reduced significantly and stem cell transplant is becoming the treatment of choice for most patients with primary refractory or recurrent Hodgkin's lymphoma. With longer follow‐up, long‐term complications, in particular secondary malignancy have become the leading cause of late treatment failure for patients with Hodgkin's lymphoma. To improve the overall outcome of patients with Hodgkin's lymphoma, future studies need to focus on reducing the therapy‐related toxicity for patients with good risk disease as well as improving disease control for patients with poor risk disease through a risk‐adapted approach. Copyright © 2001 John Wiley & Sons, Ltd.