Introduction
Very significant advances have been made in the treatment of Hodgkin lymphoma. This disease had a terrible prognosis 50 years ago.
Robert Lowell, the great American poet wrote a poem about his uncle who died of Hodgkin lymphoma. This was the outcome for most patients at that time.
"My Last Afternoon with Uncle Devereux Winslow"
The original paper was written by Thomas Hodgkin in 1832 and was entitled "On some morbid Appearances of the Absorbent Glands and Spleen."
Sternberg in 1898 and Reed in 1902 first described the histopathology of Hodgkin lymphoma precisely.
Reed in particular described the multinucleated giant cells which would be later known as "Reed- Sternberg cells." She was certain that this was not an unusual form of TB - which was the commonly held belief at the time.
Improvements in radiotherapy techniques lead to the first cures of early stage disease.
In the 1940s, there was continued work on mustard gases. Used as weapons in the first world war, they had been found to have a significant lymphocytolytic effects.
Experimental studies showed an advantage to using a combination of non-cross resistant anti-neoplastic agents (also with toxicities that didn't overlap).
In 1964 the four drug MOPP regimen was first used:
- M - Mechlorethamine (Nitrogen Mustard)
- O - Oncovin (Vincristine)
- P - Procarbazine
- P - Prednisone
This was the first effective chemotherapy for the treatment of Hodgkin lymphoma.
Presently, a different four drug combination ABVD is frequently used:
- A- Adriamycin (Doxorubicin)
- B - Bleomycin
- V - Vincristine
- D – Dacarbazine
Radiotherapy (RT) is also an important component of the treatment, but is less frequently used. When RT is necessary, the treatment fields are far less extensive than 10 to 20 years ago.
