Hodgkin’s lymphoma
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 9
Abstract
Hodgkin’s lymphoma (HL) is a chemosensitive B-cell malignant proliferation, with durable remission rates 80-90% among all treated patients. Approximately 95% of cases represent so called classical HL (cHL), whereas in the remain 5% of cases – nodular lymphocyte predominant HL (nLP HL).<br>Neoplastic cells in HL (Hodgkin/Reed-Sternberg cells – H/RS) are characterized by several molecular defects, leading to escape from apoptosis, with simultaneous clonal proliferation. H/RS cells in cHL show expression of CD30 and CD15 antigens, with lack of CD45 and EMA (epithelial membrane antigen). Moreover, they show overexpression of Bcl-2, p53, p21 or PCNA proteins, what is associated with worse prognosis in this disease. In contrast, H/RS cells in nL PHL have different immunophenotype. They show expression of B-cell markers (CD20+), somatic mutations of immunoglobulin heavy chains and expression of Bcl-6 protein.<br>Actually, polychemotherapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD regimen) provides the best balance of effectiveness and minimization of toxicity the front-line treatment. In majority of patients chemotherapy is followed by involved-field radiotherapy for early stages and long-term chemotherapy (combined modality treatment). The major goal of current clinical research in HL is optimizing treatment to limit irreversible acute and late toxicity such as infertility, cardiac disease, pulmonary dysfunction, and a risk of second neoplasms. In primary resistant or recurrent patients, the high dose chemotherapy followed by autologous stem cell transplantation (autoSCT) are actually standard of care. Treatment beyound autoSCT still remains challenge for oncohematologists. The paper reviews an actual view on the pathogenesis and standards of first-line treatment in classic HL have been described.
Authors and Affiliations
Piotr Smolewski
Keywords
Related Articles
- EP ID EP54541
- DOI -
- Views 127
- Downloads 0
Endovascular mechanical thrombectomy of primary and recurrent changes in the arteries and bypasses – preliminary own experience
Introduction. Atherosclerosis is the most common disease of lower extremity arteries and a main cause of chronic limb ischemia. Treatment options of advanced peripheral arterial disease include surgical methods (endarter...
The incidence and type of symptoms of respiratory disorders during sleep in children aged 6-12 years in parents report – own research
Introduction. Sleep disorders of breathing (SDB) in children is a clinical problem that is nowadays becoming well recognized both by patients and doctors. It can be the basis for the diagnosis of Obturative Sleep Apnea S...
Clinical and angiographic risk stratification of patients with acute coronary syndrome without ST elevation
The risk assessment of patients with acute coronary syndrome without ST segment elevation (NSTE ACS) is recommended by the European Society of Cardiology (ESC) aimed at selection of the best treatment, including invasive...
Basic EMS teams facing patient with irreversible cardiac arrest
Introduction. Emergency Medical System Enactment created Basic EMS teams, which do not have a physiscian as their member. Such teams are being dispatched also to patients with irreversilbe cardiac arrest, or those alread...
Headaches and hormonal disorders
Some endocrinological causes of headaches are well known, others are less known in daily practice. Thirty-three to seventy-two percent of pituitary adenomas induce headache. Headache is the first symptom in about 11% of...