Hodgkin Lymphoma
Write briefly on Hodgkin’s Lymphoma.
Answer. Hodgkin’s lymphoma is a lymphoproliferative disorder which arises from lymph nodes and from lymphoid Components Of Various Organs.
“Treatment Options For Hodgkin Lymphoma“
Hodgkin’s Lymphoma Clinical Features
- The tumor is seen in young adults, i.e. during 20 to 30 years or in elderly people during 5th decade of life.
- Onset of the tumor is insidious with enlargement of one group of superfiial nodes.
- Associated lymph nodes are painless. There is presence of generalized weakness, cough, dyspnea and anorexia.
- Lymph nodes are discrete and rubbery in consistency with overlying skin is purely mobile.
- Pel-Ebstein fever is present, i.e. presence ofcyclic fever with generalized severe pruritus which is of unknown etiology.
- In oral cavity, the lesion appears as an ulcer or swelling.
- It can also be present as intrabony lesion which appears as hard swelling.
“Chemotherapy Regimens For Hodgkin Lymphoma”
Ann Arbor Clinical Staging
“Early Symptoms Of Hodgkin Lymphoma”
Hodgkin’s Lymphoma Investigations
Blood test:
- Non-specifi anemia of chronic disease is common
- Lymphopenia is present.
- ESR is elevated.
Lymph node biopsy:
Show presence of Reed-Sternberg cells.
“Role Of Radiation Therapy In Hodgkin Lymphoma”
Hodgkin’s Lymphoma Imaging:
- Chest X-ray to look for mediastinal lymph nodes and pleural effusion
- CT is valuable in detecting intrathoracic and abdominal lymphadenopathy.
USG: To look for liver, spleen and abdominal lymph node.
“Signs Of Hodgkin Lymphoma In Young Adults”
Hodgkin’s Lymphoma Management
Stage I and II:
- Mainly radiotherapy, i.e. external high cobalt radiotherapy
- Above the diaphragm: Y fild therapy, covering cervical,axillary, mediastinal lymph nodes.
- Below the diaphragm: Mantle or inverted Y fild therapy covering para-aortic and iliac nodes.
- Chemotherapy is also given.
Stage III and IV:
- In this, mainly chemotherapy is given.
Regimens used are:
MoPP regimen
- Mechlorethamine: 6 mg/sqm on 1st and 8th day.
- Oncovine: 1.4 mg/sqm on 1st and 10th day.
- Procarbazine: 100 mg orally daily for 10 days.
- Prednisolone: 45 mg orally daily for 10 days.
- MOPP combination is given in 6 courses with no drugs given from 15th to 28th day.
“Swollen Lymph Nodes And Hodgkin Lymphoma: Connection Explained”
ABVd Regimen
- Adriamycin: 30 mg/sqm
- Bleomycin: 10 mg/sqm
- Vinblastine: 6 mg/sqm
- Dacarbazine: 350 mg/sqm
The cycle is repeated on 20th day.
Splenectomy is done in many patients except with stage IV disease.
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