Hodgkin disease (Hodgkin lymphoma) is a type of lymphoma, that is marked by the presence of Reed-Sternberg cells. The 4 subtypes of Hodgkin lymphoma are: Nodular sclerosis Hodgkin disease, Mixed cellularity Hodgkin disease, Lymphocyte-rich Hodgkin disease and Lymphocyte-depleted Hodgkin disease.
Hodgkin’s disease as a systemic ailment can affect multiple organ systems at the same time at any stage of the disease. The following system-wise symptomatology of Hodgkin’s disease is commonly seen in patients:
The following diagnostic procedures are used to verify and assess cases of Hodgkin’s disease in suspected individuals:
Patients with Hodgkin’s disease may benefit from these treatment modalities depending on the histologic type and stage of the disease. The main objective of the treatment regimen in Hodgkin’s disease is to eliminate as many cancer cells and bring the patient in the state of remission. The following treatment options are available for Hodgkin’s disease:
The cure rate for Hodgkin’s disease rises up to 80% in patients treated early with chemotherapy with or without radiation therapy. Patients who experience relapse in a period of 12 months from full remission carry a poor prognosis.
Attributes like age of more than 45 years old, male sex, and involvement of many extranodal sites increase the likelihood of relapse for Hodgkin’s disease. Immunocompromised hosts like patients beyond 55 years old with Epstein Barr Virus infection may have poor prognosis with Hodgkin’s disease .
The following diseases are commonly seen as a complication of Hodgkin’s disease:
The exact etiology of Hodgkin’s disease is still unknown to this date. Theories have been postulated like a B-cell mutation that causes it to be abnormally big (Reed-Sternberg cells) and to proliferate indefinitely compressing other normal cells to exert its symptomatology.
Some theories suggests the participation of the Epstein Barr Virus (EBV) in the etiology because it is present in at least 30% of Hodgkin’s disease cases .
Treatment approach and prognostic outlook differs per subtype of Hodgkin’s lymphoma. There is a close correlation between Hodgkin’s disease and family history where siblings have up to 7 folds risk of acquiring the disease when a family member has been diagnosed to have one .
The current average incidence rate of Hodgkin’s disease in the United States for both sexes is 2.9 cases per 100,000 population . According to the National Cancer Institute (NCI), at least 9,000 new cases of Hodgkin’s disease have been reported in Europe along with more than 1,100 deaths recorded for the year 2014 so far .
Hodgkin’s disease has a predilection among male children in up to 85% of cases in the United States. This disease has been found to have low incidence rate among Asians and Pacific Islanders.
Hodgkin’s lymphoma has bimodal peak observed initially in young adults (15-34 years old) with the nodular sclerosing type, and peaks again beyond 55 years old presenting with the mixed cellularity type of Hodgkin’s disease .
The pathophysiology of Hodgkin’s disease is believed to have originated in the clonal transformation of the B-cell which gives rise to the large bi-nucleate B-cells known as Reed-Sternberg cells. Other than the genetic susceptibility inherent to the individual the following environmental risk factors have noted to cause Hodgkin’s disease in an otherwise healthy host:
Because the exact mechanisms that cause Hodgkin’s disease are still unknown, no modifiable lifestyle practices can prevent the emergence of Hodgkin’s disease.
Hodgkin’s disease or Hodgkin’s lymphoma is a clinical disorder characterized by localized or disseminated of proliferation of the lymphoreticular system of the body. These carcinogenic degeneration involves the spleen, lymph nodes, liver and the bone marrow.
The abnormal proliferation of lymphatic cells may compromise the immune system of the patient. The advances in medical science have allowed us to discover Hodgkin’s disease early in its clinical course and which has dramatically improved the prognosis in patients with this disease.
The World Health Organization (WHO) have classified Hodgkin’s lymphoma into five distinct types according to histology: The lymphocyte rich, lymphocyte depleted, mixed cellularity, nodular sclerosing and the nodular lymphocyte predominant types .
Hodgkin’s disease or Hodgkin’s lymphoma is a localized or disseminated cancer of the lymphoreticular system of the body.
Hodgkin’s disease is caused by a clonal mutation of the B-cells that gives rise to the large bi-nucleated Reed-Sternberg’s cells causing compression signs in the bone marrow, spleen, lymph nodes and liver. This inherently lowers the immune response of the patients.
Lymph node and bone marrow biopsy confirms the diagnosis of Hodgkin’s disease where the patient is submitted for immediate treatment.
Treatment and follow up
Diagnosed patients are treated in combination of radiotherapy and chemotherapy. After both therapies, a stem cell replacement is performed to replace bone marrow cells with a new and healthy stem cell. Patients should be vigilant of a possible relapse within 12 months from the start of treatment.