Treatment Of Hodgkin's Disease

In stage I and II radiation can abort Hodgkin's disease that is present in a specific local area with very good cancer survival rates. Stage III and IV needs quite sophisticated multi drug chemotherapy followed often by radiotherapy. At present the best combination seems to be doxorubicin, bleomycin, vinblastine and dacarbazine. There are differences, as mentioned earlier, depending on the cell type and the stage the lymphoma is in at the time of diagnosis. Here is a survival table for a low-grade Hodgkin's disease:

Note: Patients in the table above were only treated with radiotherapy for stage I and II. Stage III and IV patients of these patients with low-grade Hodgkin's disease were first treated with combination chemotherapy and then with radiotherapy, if indicated.

Patients who do not respond with a complete remission or who relapse within 6 to 12 months following initial chemotherapy, have a very poor prognosis.

The only hope for long-term survival then is a bone marrow transplantation. In selected patients, who will withstand the initial high chemotherapy dosage to wipe out the Hodgkin's cells in the system, a bone marrow transplantation can yield cure rates in more than 50% of patients. Unfortunately not every patient with a poor prognosis will be eligible for this vigorous therapy.

Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. N Engl J Med 329(14):987-994,1997.

2. The Merck Manual of Diagnosis and Therapy. 17th edition, editors M.Beers and     R.Berkow. Whitehouse Station, N.J., 1999.

3. Cancer: Principles & Practice of Oncology. 4th edition, edited by V.T. DeVita et al.,      Lippincott Co., Philadelphia, 1993. Chapters 51 and 52.

4. Cancer: Principles&Practice of Oncology. 5th edition, volume 2. Edited by Vincent T.     DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Chapter 44,Lymphomas.

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