Hodgkin's Lymphoma or Hodgkin's Disease

Hodgkin's lymphoma, also known as Hodgkin's disease, is a type of lymphoma (cancer of the lymphatic system) first described by Thomas Hodgkin in 1832. Hodgkin's lymphoma is characterized clinically by the orderly spread of disease from one lymph node group to another and by the development of systemic symptoms with advanced disease. Pathologically, the disease is characterized by the presence of Reed-Sternberg cells.

Hodgkin's lymphoma was one of the first cancers to be cured by radiation. Later it was one of the first to be cured by combination chemotherapy. The cure rate is currently about 93%, making it one of the most curable forms of cancer—if it is detected in the early stages. Later-stage cancers show a significantly worse prognosis. The Handbook of Cancer Chemotherapy, Sixth Edition states that "the potential for cure should not lead clinicians and patients to lose sight of the fact that [Hodgkin's lymphoma] is a form of cancer and that approximately 20% to 25% of patients...die of the disease."

Types

Classical Hodgkin's lymphoma (excluding nodular lymphocyte predominant Hodgkin's) can be subclassified into 4 subtypes based upon Reed-Sternberg cell appearances and the composition of the reactive cell infiltrate seen in the lymph node biopsy specimen.

Family	Name	Description
Classical	Nodular sclerosing CHL	Is the most common subtype and is composed of large tumor nodules with lacunar RS cells subtype composed of numerous classic often pleomorphic RS cells with only few reactive lymphocytes which may easily be confused with diffuse large cell lymphoma.
Classical	Mixed-cellularity subtype	Is a common subtype and is composed of numerous classic RS cells admixed with numerous inflammatory cells including lymphocytes, histiocytes, eosinophils, and plasma cells.
Classical	Lymphocyte-rich	Is a rare subtype.
Classical	Lymphocyte depleted	Is a rare subtype.
Non-classical	Nodular lymphocyte predominant Hodgkin's lymphoma (NLPHL)	Is no longer classified as a form of classic Hodgkin's lymphoma. This is due to the fact that the RSC variants (popcorn cells) that characterize this form of the disease invariably express B lymphocyte markers such as CD20 (thus making NLPHL an unusual form of B cell non-Hodgkin's lymphoma), and that (unlike classic HL) NLPHL may progress to diffuse large B cell lymphoma. There are small but clear differences in prognosis between the various forms. Lymphocyte predominant HL is an uncommon subtype composed of vague nodules of numerous reactive lymphocytes admixed with large popcorn-shaped RSC. Unlike classic RSC, the non-classic popcorn-shaped RS cells of NLPHL are CD15 and CD30 negative while positive for the B cell marker CD20.

Treatment

Treatment has varied over the years as can be seen on the timeline. Treatment now is often determined by medical professionals based on the spread of the disease (stage), type noted above, sex, large number of involved nodal sites, age, the presence of B symptoms, high erythrocyte sedimentation rate, and bulky disease.

Currently, most often combination chemotherapy is used although for early stage Hodgkin's (caught early) radiation may also be used. Again the timeline has a list of treatments tried according to year.

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Source: Wikipedia - Hodgkin's lymphoma accessed 6-21-2008

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