New developments in staging and follow-up of patients with Hodgkin's lymphoma

Adequate staging of newly diagnosed patients with Hodgkin's lymphoma enables optimal treatment planning, which is of particular importance for finding a balance between treatment efficacy and toxicity. In this review an overview is given of the current knowledge on initial staging and the role of imaging modalities during and after treatment. A promising new tool is whole-body positron emission tomograpy (PET) scanning with fluorodeoxyglucose (FDG). This modality is particularly useful for the evaluation of a residual mass at the end of treatment and for the assessment of the prognostically relevant 'early response' to chemotherapy. Although high survival rates have been reported for patients treated within the context of clinical trials these rates are generally lower in population-based series. In the general population comorbidity is present in half of all elderly Hodgkin patients. Since comorbidity has great impact on treatment planning and survival, this prognostic factor should be taken into account in future trials.