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Hodgkin Lymphoma





As with all tumors, management involves a multidisciplinary team:


1.  Surgery

  • Excisional biopsy is usually done to make the diagnosis
  • Staging laparotomy - no longer done on a routine basis
    • Extent of disease can be accurately assessed with PET-CT scan.
    • Chemotherapy is so effective that it no longer matters if microscopic splenic disease is missed on a CT scan 
    • Splenectomy has many long term adverse consequences (altered immunity and risk of septicemia)
  • Therapy - surgery is only used as therapy in the setting of Stage IA lymphocyte predominant Hodgkin lymphoma.


2. Chemotherapy

  • Hodgkin lymphoma is very sensitive to chemotherapy.
  • Combined chemotherapy and RT has resulted in the cure of 80 - 90% of patients with Hodgkin lymphoma.


3. Radiation Therapy (RT)

  • Treatment used to involve extensive lymph node regions (mantle field and or upper abdomen to include spleen and para-aortic regions)
  • Now limited generally to "involved fields" - sites of bulky disease at presentation and persistent areas of PET avid disease after chemotherapy.


External Link:

Treatment approach for children and adolescents with HL at the National Cancer Institute



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