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[Hodgkin lymphoma].

Jun Itami

    Nihon Igaku Hoshasen Gakkai Zasshi. Nippon Acta Radiologica
    |June 5, 2002
    PubMed
    Summary

    The WHO now classifies Hodgkin's disease as Hodgkin lymphoma, a germinal center B-cell cancer. New management strategies, including risk-adapted therapy and advanced radiation, improve outcomes while minimizing long-term risks.

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    Area of Science:

    • Hematology
    • Oncology
    • Pathology

    Context:

    • The World Health Organization (WHO) classification for hematopoietic and lymphoid tumors has been updated.
    • Hodgkin's disease is now recognized as Hodgkin lymphoma, confirming its germinal center B-cell origin.
    • Nodular lymphocyte-predominant Hodgkin lymphoma is a newly identified entity with a favorable prognosis.

    Purpose:

    • To outline the updated WHO classification for Hodgkin lymphoma.
    • To describe current management strategies based on risk stratification.
    • To review the long-term morbidities associated with Hodgkin lymphoma treatment.

    Summary:

    • The updated WHO classification renames Hodgkin's disease to Hodgkin lymphoma and introduces nodular lymphocyte-predominant Hodgkin lymphoma.
    • Management employs a risk-adapted approach, avoiding staging laparotomy.
    • For limited stages, subtotal nodal irradiation offers >80% cure rates.
    • Multimodality therapy improves disease-free survival but not overall survival.
    • Advanced stages rely on chemotherapy, with radiation as adjuvant therapy.
    • Long-term follow-up reveals increased risks of solid malignancies and ischemic heart disease, potentially linked to mantle irradiation.

    Impact:

    • Modern radiation therapy techniques reduce long-term morbidities.
    • Meticulous radiation therapy remains crucial for local control of Hodgkin lymphoma.
    • Understanding these updates aids in optimizing treatment and patient follow-up for Hodgkin lymphoma.

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