Hodgkin's lymphoma: Pathogenesis, diagnosis, treatment options and prognosis

A. Illés, Ádám Jóna, László Váróczy, Zsófia Miltényi, Zsófia Simon, Peter Szodoray

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Hodgkin's lymphoma (HL) is a rare monoclonal lymphoid malignancy of B-cell origin, which represents circa 12-18 % of all lymphomas. It shows characteristic clinical and morphological features. The disease remains localised for a long period of time. The histological characteristics are the bilobated Hodgkin and Reed-Sternberg (HRS) cells for classical HL, and their variants the lymphocytic and hystiocytic (LandH) cells, for nodular lymphocyte predominant HL, surrounded by large, non-malignant, reactive tissue. Both pathognomonic HRS and LandH cells go through somatic hypermutation. Phenotypically HRS cells are CD15 and CD30 positive, while LandH cells are CD20 positive. The exact etiology is still unknown, however the role of genetical, immunological and viral infection (Ebstein-Barr virus) seem important. Environmental factors might explain, why deficient response against HRS cells occurs. More than half of the HL patients have no complaints, lymphadenomegaly and hepato-splenomegaly can be seen at the time of the diagnosis, while B symptoms (fever, night sweats and loss of weight) are more specific for advanced stage. Patients suspect to HL go through a specific check-up, lymph node and bone marrow biopsy for histological diagnosis and various imaging techniques (ultrasound, X-ray, CT or, 18FDG PET/CT scan) for staging. Nowadays the standard combined chemo-radiotherapy consisting of adriamycin bleomycin vinblastine dacarbazine (ABVD) regimen is expected to cure 80-85% of patients. Risk-adapted strategy involving conventional prognostic factors, such as the European Organization for Research and Treatment of Cancer (EORTC), in early and International Prognostic Score (IPS) in advanced stage HL are known to avoid over-and under-treating patients. The early identification of refractory patients by interim PET/CT may be beneficial thus further improves patient outcome and help to avoid late side effects. Combining standard care with novel epigenetic and targeted therapies (anti-CD20 and anti-CD30 antibodies) may be promising and clinical trials currently take place to assess the efficacy of these novel treatment regimes.

Original languageEnglish
Title of host publicationHodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis
PublisherNova Science Publishers, Inc.
Pages91-113
Number of pages23
ISBN (Print)9781622574780
Publication statusPublished - Nov 2012

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Hodgkin Disease
Chemoradiotherapy
Dacarbazine
Computerized tomography
Lymphocytes
Vinblastine
Biopsy
Bleomycin
Fluorodeoxyglucose F18
Viruses
Refractory materials
Doxorubicin
Reed-Sternberg Cells
Bone
Ultrasonics
Cells
Tissue
Imaging techniques
X rays
Antibodies

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Illés, A., Jóna, Á., Váróczy, L., Miltényi, Z., Simon, Z., & Szodoray, P. (2012). Hodgkin's lymphoma: Pathogenesis, diagnosis, treatment options and prognosis. In Hodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis (pp. 91-113). Nova Science Publishers, Inc..

Hodgkin's lymphoma : Pathogenesis, diagnosis, treatment options and prognosis. / Illés, A.; Jóna, Ádám; Váróczy, László; Miltényi, Zsófia; Simon, Zsófia; Szodoray, Peter.

Hodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis. Nova Science Publishers, Inc., 2012. p. 91-113.

Research output: Chapter in Book/Report/Conference proceedingChapter

Illés, A, Jóna, Á, Váróczy, L, Miltényi, Z, Simon, Z & Szodoray, P 2012, Hodgkin's lymphoma: Pathogenesis, diagnosis, treatment options and prognosis. in Hodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis. Nova Science Publishers, Inc., pp. 91-113.
Illés A, Jóna Á, Váróczy L, Miltényi Z, Simon Z, Szodoray P. Hodgkin's lymphoma: Pathogenesis, diagnosis, treatment options and prognosis. In Hodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis. Nova Science Publishers, Inc. 2012. p. 91-113
Illés, A. ; Jóna, Ádám ; Váróczy, László ; Miltényi, Zsófia ; Simon, Zsófia ; Szodoray, Peter. / Hodgkin's lymphoma : Pathogenesis, diagnosis, treatment options and prognosis. Hodgkin's and T-Cell Lymphoma: Diagnosis, Treatment Options and Prognosis. Nova Science Publishers, Inc., 2012. pp. 91-113
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