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'''For the WikiDoc page for this topic, click [[Hodgkin's lymphoma|here]]'''


'''Editor-in-Chief:''' Jinhui Wu
{{Hodgkin's lymphoma (patient information)}}


{{EJ}}
'''Editor-in-Chief:''' [[C. Michael Gibson]], M.S.,M.D. [mailto:charlesmichaelgibson@gmail.com]  Phone:617-632-7753; '''Associate Editor-In-Chief:''' Jinhui Wu, MD


==What is Hodgkin's lymphoma?==
==Overview==
Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.
==What are the symptoms of Hodgkin's lymphoma?==
* Fatigue
* Fever and chills that come and go
* Itching all over the body that cannot be explained
* Loss of appetite
* Soaking night sweats
* Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
* Weight loss that cannot be explained


There are two kinds of lymphoma: Hodgkin disease and Non-Hodgkin's lymphoma. Hodgkin disease is also called Hodgkin lymphoma, which is named after Dr. Thomas Hodgkin who recognized the disease in 1832. Hodgkin's lymphoma is rare in America. Usual symptoms include painless swelling of the lymph nodes in the neck, armpits, or groin, fever and chills, night sweats, and so on. Hodgkin's lymphoma can be diagnosed by biopsy. Treatment includes radiation therapy, chemotherapy, high dose chemotherapy and bone marrow or peripheral blood stem cell transplantand and a combination of them.
Other symptoms that may occur with this disease:
* Coughing, chest pains, or breathing problems if there are swollen lymph nodes in the chest
* Excessive sweating
* Pain or feeling of fullness below the ribs due to swollen spleen or liver
* Pain in lymph nodes after drinking alcohol
* Skin blushing or flushing


==How do I know if I have Hodgkin's lymphoma and what are the symptoms of Hodgkin's lymphoma?==
Note: Symptoms caused by Hodgkin's lymphoma may also occur also with other conditions. Talk to your doctor about the meaning of your specific symptoms.


Early Hodgkin's lymphoma does not have any symptoms. People may notice one or more of the following symptoms as the tumor developing or when detected by regular examinations:
==Who is at highest risk?==
 
:*Painless swelling of the lymph nodes in the neck, armpits, or groin
 
:*Fever and chills
 
:*Night sweats
 
:*Weight loss
 
:*Loss of appetite
 
:*Itchy skin
 
Other health problems may also cause these symptoms. Only a doctor can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.
 
==Who is at risk for Hodgkin's lymphoma?==


Clinical data has suggested that the development of Hodgkin's lymphoma is related to several factors.  
Clinical data has suggested that the development of Hodgkin's lymphoma is related to several factors.  


:*Epstein-Barr Virus (EBV) infection/Mononucleosis: The role of EBV in the development of Hodgkin lymphoma is not very clear. As we know, mononucleosis is an infection caused by the Epstein-Barr virus (EBV). Clinical data show that mononuclesis has a close relationship with Hodgkin's lymphoma.
*'''Epstein-Barr Virus (EBV) infection/Mononucleosis:''' The role of EBV in the development of Hodgkin lymphoma is not very clear. As we know, mononucleosis is an infection caused by the Epstein-Barr virus (EBV). Clinical data show that mononuclesis has a close relationship with Hodgkin's lymphoma.


:*Family history: The reason why family history may increase risk of developing Hodgkin's lymphoma is not clear. Some researchers proclaimed they had found certain changes in the genes responsible for immunity in patients with Hodgkin's lymphoma.  
*'''Family history:''' The reason why family history may increase risk of developing Hodgkin's lymphoma is not clear. Some researchers proclaimed they had found certain changes in the genes responsible for immunity in patients with Hodgkin's lymphoma.  


:*Socioeconomic status: Clinical survey shows patients with Hodgkin's lymphoma posses higher socioeconomic background. The reason is not clear.  
*'''Socioeconomic status:''' Clinical survey shows patients with Hodgkin's lymphoma posses higher socioeconomic background. The reason is not clear.  


:*Geography: Epidemiological data demonstrates that Hodgkin's lymphoma is most common in western countries such as the United States, Canada and northern Europe, and is least common in Asian countries.  
*'''Geography:''' Epidemiological data demonstrates that Hodgkin's lymphoma is most common in western countries such as the United States, Canada and northern Europe, and is least common in Asian countries.  


:*Age: Epidemiological survey suggests that Hodgkin's lymphoma is most common in early adulthood (ages 15 to 40, especially in a person's 20s) and in late adulthood (after age 55).
*'''Age:''' Epidemiological survey suggests that Hodgkin's lymphoma is most common in early adulthood (ages 15 to 40, especially in a person's 20s) and in late adulthood (after age 55).


:*Gender: Hodgkin's lymphoma occurs slightly more often in men than in women.
*'''Gender:''' Hodgkin's lymphoma occurs slightly more often in men than in women.


==How to know you have Hodgkin's lymphoma?==
==When to seek urgent medical care?==


:*Lymph nodes biopsy and immunohistochemistry: Many of the symptoms of Hodgkin's lymphoma are not specific enough to say for certain. They can also be caused by non-cancerous problems or by other kinds of cancers. As we stated before, painless swelling of the lymph nodes in the neck, armpits, or groin may be the most common symptom of Hodgkin's lymphoma. So biopsy may be the most valuable test. The goal of a biopsy is to get enough of a sample to identify the diagnosis, as well as the type of the disease. Usual types of biopsy include excisional or incisional biopsy, fine needle aspiration (FNA) or core needle biopsy and bone marrow aspiration and biopsy. After checked under the microsope by the pathologists, sometimes the samples need to further test by immunohistochemistry.
Call your health care provider if symptoms of Hodgkin's lymphoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
*[[Hyperpyrexia]] and severe [[chills]]
*Severe [[infection]]


:*Images tests such as computed tomography (CT) scan, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, ultrasound and chest-x-ray: The goal of these image tests are to help find out the extent of the Hodgkin's lymphoma and determine the stage of the disease.
==Diagnosis==
The first sign of Hodgkin's lymphoma is often a swollen lymph node, which appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.


==When to seek urgent medical care?==
The disease may be diagnosed after:


Call your health care provider if symptoms of Hodgkin's lymphoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:
* Biopsy of suspected tissue, usually a lymph node biopsy
* Bone marrow biopsy
* If tests reveal that you do have Hodgkin's lymphoma, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide treatment and follow-up, and gives you some idea of what to expect in the future.


:*Hyperpyrexia and severe chills
The following procedures will usually be done:


:*Severe infection
* Blood chemistry tests including protein levels, liver function tests, kidney function tests, and uric acid level
* Bone marrow biopsy
* CT scans of the chest, abdomen, and pelvis
* Complete blood count (CBC) to check for anemia and white blood count
* PET scan
* Some people may need abdominal surgery to take out a piece of the liver and remove the spleen. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually not needed.


==Treatment options==
==Treatment options==
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.


Patients with Hodgkin's lymphoma have many treatment options. The selection depends on the stage of the disease. The options are radiation therapy, chemotherapy and high dose chemotherapy and bone marrow or peripheral blood stem cell transplant. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects may not be the same for each person, and they may change from one treatment session to the next.  
Treatment depends on your age and stage of the cancer.


:*Chemotherapy: This treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing. Doctors give chemotherapy in cycles and each chemotherapy cycle generally lasts for several weeks. The most common regimen used in the United States is ABVD regimen, which includes Adriamycin, Bleomycin, Vinblastine and Dacarbazine.
* 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 (using stem cells from yourself).
What other treatments you have depend on your symptoms, but may include:


:*Radiation therapy: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation. Radiation is also used together with chemotherapy when the Hodgkin's lymphoma involves a large tumor mass.
Transfusion of blood products, such as platelets or red blood cells, to fight low platelet counts and anemia
 
Antibiotics to fight infection, especially if a fever occurs
:*High dose chemotherapy and bone marrow or peripheral blood stem cell transplant: In this treatment, at first higher doses of chemical drugs (sometimes along with radiation therapy) may be given to patients to obtain more effective. Then, the patient receives a transplant of blood-forming stem cells to restore the bone marrow.


==Diseases with similar symptoms==
==Diseases with similar symptoms==
Line 71: Line 90:
Other health problems may also cause similar symptoms. Go to see your doctor to verify your diseases as early as possible. Diseases with similar symptoms are listed in the following:  
Other health problems may also cause similar symptoms. Go to see your doctor to verify your diseases as early as possible. Diseases with similar symptoms are listed in the following:  


:*[[Lymph nodes reactive hyperplasia]]
*Lymph nodes reactive hyperplasia


:*[[Non-Hodgkin's lymphoma]]
*[[Non-Hodgkin lymphoma]]


:*[[Chronic lymphocytic leukemia]]
*[[Chronic lymphocytic leukemia]]


:*[[Chronic neutrophilic leukemia]]
*[[Chronic neutrophilic leukemia]]


==Where to find medical care for Hodgkin's lymphoma?==
==Where to find medical care for Hodgkin's lymphoma?==
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[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Hodgkin's disease}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Hodgkin's disease]
[http://maps.google.com/maps?f=q&hl=en&geocode=&q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Hodgkin's disease}}}}&sll=37.0625,-95.677068&sspn=65.008093,112.148438&ie=UTF8&ll=37.0625,-95.677068&spn=91.690419,149.414063&z=2&source=embed Directions to Hospitals Treating Hodgkin's disease]


==Prevention of Hodgkin's lymphoma==
==Prevention==


Hodgkin's lymphoma is not related with life style, so there is no known risk factors for people to change at present. But more researches are needed to verify.
Hodgkin's lymphoma is not related with life style, so there is no known risk factors for people to change at present. But more researches are needed to verify.
Line 89: Line 108:
==What to expect (Outook/Prognosis)?==
==What to expect (Outook/Prognosis)?==


The prognosis of Hodgkin's lymphoma suggested by the international study depends on:
Hodgkin's disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is often very curable, even in its late stages.


:*The stage of Hodgkin's lymphoma
With the right treatment, more than 90% of people with stage I or II Hodgkin's lymphoma survive for at least 10 years. If the disease has spread, the treatment may be more intense. However, 90% of people with advanced disease survive for at least 5 years.


:*Lymphocyte count and white blood count
Patients who survive 15 years after treatment are more likely to later die from other causes, including complications of the treatment, rather than from Hodgkin's disease.


:*Hemoglobin and albumin level
People with Hodgkin's lymphoma whose disease returns within a year after treatment or who do not respond to the first treatment have a poorer outlook.


:*Patient's age and gender
You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor check for signs of the cancer returning, and for any long-term treatment effects.
==Possible complications==
Treatments for Hodgkin's lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include:


==Copyleft Sources==
* 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. To reduce bleeding, apply ice and pressure. Use a soft toothbrush and electric razor for personal hygiene.
Always take an infection seriously during cancer treatments. Contact your doctor right away if you develop fever or other signs of infection, especially if your white blood cell counts are low due to treatment. Planning rest periods during your daily activities may help prevent fatigue due to anemia.


http://www.cancer.gov/cancertopics/types/hodgkin
==Sources==
*http://www.nlm.nih.gov/medlineplus/ency/article/000580.htm


http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_Hodgkins_disease_20.asp?sitearea=CRI
*http://www.cancer.gov/cancertopics/types/hodgkin
 
*http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_Hodgkins_disease_20.asp?sitearea=CRI


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[[Category:Patient Information]]
 
[[Category:Patient information]]
[[Category:Disease]]
[[Category:Hematology]]
[[Category:Types of cancer]]
[[Category:Rare diseases]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Immunology]]

Latest revision as of 22:12, 29 July 2020

For the WikiDoc page for this topic, click here

Hodgkin's lymphoma

Overview

What are the symptoms?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Diseases with similar symptoms

Where to find medical care for Hodgkin's lymphoma?

Prevention

What to expect (Outlook/Prognosis)?

Hodgkin's lymphoma On the Web

Ongoing Trials at Clinical Trials.gov

Images of Hodgkin's lymphoma

Videos on Hodgkin's lymphoma

FDA on Hodgkin's lymphoma

CDC on Hodgkin's lymphoma

Hodgkin's lymphoma in the news

Blogs on Hodgkin's lymphoma

Directions to Hospitals Treating Hodgkin's lymphoma

Risk calculators and risk factors for Hodgkin's lymphoma

Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Jinhui Wu, MD

Overview

Hodgkin's lymphoma is a cancer of lymph tissue found in the lymph nodes, spleen, liver, bone marrow, and other sites.

What are the symptoms of Hodgkin's lymphoma?

  • Fatigue
  • Fever and chills that come and go
  • Itching all over the body that cannot be explained
  • Loss of appetite
  • Soaking night sweats
  • Painless swelling of the lymph nodes in the neck, armpits, or groin (swollen glands)
  • Weight loss that cannot be explained

Other symptoms that may occur with this disease:

  • Coughing, chest pains, or breathing problems if there are swollen lymph nodes in the chest
  • Excessive sweating
  • Pain or feeling of fullness below the ribs due to swollen spleen or liver
  • Pain in lymph nodes after drinking alcohol
  • Skin blushing or flushing

Note: Symptoms caused by Hodgkin's lymphoma may also occur also with other conditions. Talk to your doctor about the meaning of your specific symptoms.

Who is at highest risk?

Clinical data has suggested that the development of Hodgkin's lymphoma is related to several factors.

  • Epstein-Barr Virus (EBV) infection/Mononucleosis: The role of EBV in the development of Hodgkin lymphoma is not very clear. As we know, mononucleosis is an infection caused by the Epstein-Barr virus (EBV). Clinical data show that mononuclesis has a close relationship with Hodgkin's lymphoma.
  • Family history: The reason why family history may increase risk of developing Hodgkin's lymphoma is not clear. Some researchers proclaimed they had found certain changes in the genes responsible for immunity in patients with Hodgkin's lymphoma.
  • Socioeconomic status: Clinical survey shows patients with Hodgkin's lymphoma posses higher socioeconomic background. The reason is not clear.
  • Geography: Epidemiological data demonstrates that Hodgkin's lymphoma is most common in western countries such as the United States, Canada and northern Europe, and is least common in Asian countries.
  • Age: Epidemiological survey suggests that Hodgkin's lymphoma is most common in early adulthood (ages 15 to 40, especially in a person's 20s) and in late adulthood (after age 55).
  • Gender: Hodgkin's lymphoma occurs slightly more often in men than in women.

When to seek urgent medical care?

Call your health care provider if symptoms of Hodgkin's lymphoma develop. If you experience either of the following symptoms, seeking urgent medical care as soon as possible:

Diagnosis

The first sign of Hodgkin's lymphoma is often a swollen lymph node, which appears without a known cause. The disease can spread to nearby lymph nodes. Later it may spread to the spleen, liver, bone marrow, or other organs.

The disease may be diagnosed after:

  • Biopsy of suspected tissue, usually a lymph node biopsy
  • Bone marrow biopsy
  • If tests reveal that you do have Hodgkin's lymphoma, more tests will be done to see if the cancer has spread. This is called staging. Staging helps guide treatment and follow-up, and gives you some idea of what to expect in the future.

The following procedures will usually be done:

  • Blood chemistry tests including protein levels, liver function tests, kidney function tests, and uric acid level
  • Bone marrow biopsy
  • CT scans of the chest, abdomen, and pelvis
  • Complete blood count (CBC) to check for anemia and white blood count
  • PET scan
  • Some people may need abdominal surgery to take out a piece of the liver and remove the spleen. However, because the other tests are now so good at detecting the spread of Hodgkin's lymphoma, this surgery is usually not needed.

Treatment options

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 your age and 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 (using stem cells from yourself).

What other treatments you have depend on your symptoms, but may include:

Transfusion of blood products, such as platelets or red blood cells, to fight low platelet counts and anemia Antibiotics to fight infection, especially if a fever occurs

Diseases with similar symptoms

Other health problems may also cause similar symptoms. Go to see your doctor to verify your diseases as early as possible. Diseases with similar symptoms are listed in the following:

  • Lymph nodes reactive hyperplasia

Where to find medical care for Hodgkin's lymphoma?

Directions to Hospitals Treating Hodgkin's disease

Prevention

Hodgkin's lymphoma is not related with life style, so there is no known risk factors for people to change at present. But more researches are needed to verify.

What to expect (Outook/Prognosis)?

Hodgkin's disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is often very curable, even in its late stages.

With the right treatment, more than 90% of people with stage I or II Hodgkin's lymphoma survive for at least 10 years. If the disease has spread, the treatment may be more intense. However, 90% of people with advanced disease survive for at least 5 years.

Patients who survive 15 years after treatment are more likely to later die from other causes, including complications of the treatment, rather than from Hodgkin's disease.

People with Hodgkin's lymphoma whose disease returns within a year after treatment or who do not respond to the first treatment have a poorer outlook.

You will need to have regular exams and imaging tests for years after your treatment. This helps your doctor check for signs of the cancer returning, and for any long-term treatment effects.

Possible complications

Treatments for Hodgkin's lymphoma can have complications. Long-term complications of chemotherapy or radiation therapy include:

  • 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. To reduce bleeding, apply ice and pressure. Use a soft toothbrush and electric razor for personal hygiene.

Always take an infection seriously during cancer treatments. Contact your doctor right away if you develop fever or other signs of infection, especially if your white blood cell counts are low due to treatment. Planning rest periods during your daily activities may help prevent fatigue due to anemia.

Sources

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