Hodgkin's lymphoma medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sowminya Arikapudi, M.B,B.S. [2]

Overview

The optimal therapy for Hodgkin's lymphoma depends on the stage at diagnosis, age, type, and size of tumor. The predominant therapy for Hodgkin's lymphoma is chemotherapy. Adjunctive radiation may be required.

Medical Therapy

Treatment depends on the following:

• The type of Hodgkin's lymphoma (most people have classic Hodgkin's)
• The stage (where the disease has spread)
• Whether the tumor is more than 4 inches (10 cm) wide
• Your age and other medical issues
• Other factors, including weight loss, night sweats, and fever
• Tests will be done to see if the cancer has spread. This is called staging. Staging helps guide future treatment and follow-up and gives you some idea of what to expect in the future. Staging is needed to determine your treatment plan. Stages of Hodgkin's lymphoma range from I to IV. The higher the staging number, the more advanced the cancer.

Treatment depends on stage of the cancer:

• Stages I and II (limited disease) can be treated with radiation therapy, chemotherapy, or both.
• Stage III is treated with chemotherapy alone, or a combination of radiation therapy and chemotherapy.
• Stage IV (extensive disease) is most often treated with chemotherapy alone.
• People with Hodgkin's lymphoma that returns after treatment or does not respond to the first treatment may receive high-dose chemotherapy. That is followed by an autologous stem cell transplant.

Chemotherapy

• Drug Regimen: (MOPP) Mustargen AND Oncovin AND Prednisone AND Procarbazine
• Drug Regimen: (ABVD) Adriamycin AND Bleomycin AND Vinblastine AND Dacarbazine
• Drug Regimen: (Stanford V) Adriamycin AND Bleomycin AND Vinblastine AND Mechlorethamine AND Etoposide AND Prednisone AND Radiation therapy
• Drug Regimen: (BEACOPP) Bleomycin AND Etoposide AND Adriamycin AND Cyclophosphamide AND Oncovin AND Procarbazine AND Prednisone

Radiotherapy

• Radiation oncologists deliver external beam radiation therapy to the lymphoma from a machine called linear accelerator which produces high energy X Rays and electrons. Patients usually describe treatments as painless and similar to getting an X-ray. Treatments last less than 30 minutes each.
• For lymphomas, there are a few different ways radiation oncologists target the cancer cells.

• Involved field radiation is when the radiation oncologists give radiation only to those parts of the patient's body known to have the cancer. Very often, this is combined with chemotherapy.
• Radiation therapy directed above the diaphragm to the neck, chest and/or underarms is called mantle field radiation.
• Radiation to below the diaphragm to the abdomen, spleen and/or pelvis is called inverted-Y field radiation.
• Total nodal irradiation is when the therapist gives radiation to all the lymph nodes in the body to destroy cells that may have spread.

Long-term complications of chemotherapy or radiation therapy

• Bone marrow diseases (such as leukemia)
• Heart disease
• Inability to have children (infertility)
• Lung problems
• Other cancers
• Thyroid problems
• Chemotherapy can cause low blood cell counts, which can lead to an increased risk of bleeding, infection, and anemia.

References

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