hodgkin's disease

Hodgkin's disease

Fact sheet drafted by the French society of Hematology doctors (March 2009)
Your doctor just diagnosed you
a Hodgkin's disease.
Hodgkin is the name of the doctor who has identified for
the first time this disease, in 1832.
Hodgkin's disease is a form of
Lymphoma, also known as lymphoma
Hodgkin.
Lymphoma is a disease linked to proliferation
malignant cells of the immune system. These
cells are located at the level of the lymph nodes
lymphatic, lymph, of the spleen and the
bone marrow.
It is in the lymph nodes that the
pathogens are neutralized by cells
immune.

The occurrence of the Hodgkin lymphoma is linked to uncontrolled multiplication
of abnormal B-lymphocytes; other morphological characteristics
specific, these abnormal cells are called 'cells of ReedSternberg.
». Lymphocytes are white blood cells that have to
purpose the production of antibodies. They circulate in the blood vessels and
lymph. When one of them becomes abnormal, it proliferate because it multiplies
faster and live longer than normal cells. The accumulation
of these malignant cells eventually form one or more tumors. These
usually develop in lymph nodes, most often
in the neck, but can also affect the spleen, the bone marrow or
other bodies.
The causes of the Hodgkin Lymphoma remain unknown. Different
risk factors that may promote the occurrence of this disease have
been identified: it is for example the epstein Barr virus infections
(responsible for Mononucleosis). It also seems that factors
Genetics can intervene. Like all cancers, Hodgkin's disease
is not contagious.
Hodgkin lymphoma is a cancer relatively infrequent. In France,.
about 1300 new cases are diagnosed each year, representing
0.5% of all new cancer cases. This disease can occur
at any age, but it is more common in young adults. It touches
slightly more men (54%) than women. It is observed two peaks of
frequency, around 30 years old, the other after 60 years. The median age at the time
the diagnosis is 35.The first symptoms
The most frequent sign at the beginning of the disease is the increase in the size
of one or several nodes. Rarely painful, these are often
located at the level of the neck or underarms, but they can be present in
other parts of the body, the thorax and abdomen in particular. When they are
large, these glands can cause various disorders, especially
cough and respiratory discomfort for the lymph nodes in the chest.
Other more general and non-specific symptoms may also be
manifest, including fever, unexplained weight loss, sweats
abundant Nocturnes, itching and tiredness.
The diagnosis
The diagnosis of Hodgkin's disease is formally established from a
biopsy, which involves taking a sample of tissue to a level of
lymph nodes whose volume has increased. The cells in the sample
are then examined under a microscope by a pathologist, i.e.
a doctor who specializes in the study of tissues. The presence of ReedSternberg cells
allows to assert the diagnosis of the disease and to specify its type
based on other cells present in the pathological ganglion around
those of Reed-Sternberg.
Other tests are usually done in order to clarify the extension of
the disease and its stage of development. Several Imaging tests are Hodgkin's disease (continued)

The different stages of the disease
Designed in 1971 by a group of experts
international classification of Ann Arbor
to distinguish the different stages of evolution
of Hodgkin's disease. It distinguishes four stages:
-Stage I corresponds to a localized to one disease
one group of lymph nodes or a single body.
-Stage II refers to a localized in disease
several groups of lymph nodes located on the same side
the diaphragm (part lower or higher of the)
body).
-Stage III is consistent with a disease
in several groups of lymph nodes located some
both sides of the diaphragm (part and lower part
upper part of the body).
-Stage IV coincides with a disease that
scope to one or several organs (lungs, the)
liver or bones for example).
Each stage is divided into two subcategories
main: A and B. In the absence of symptoms, the
disease is classified A, symptoms
(fever, night sweats, loss of weight, for example),
She said B. With this classification, it is said by
example, the disease is AI or IIIB.
Association France Lymphoma hope
 Association of patients D
Useful contacts
• Secretariat/date:
• Nursing consultation:
• Consulting psychologist:
• Social worker:
• In case of emergency:
Participate in a clinical trial
The best way to advance support
disease is to treat patients within the framework
therapeutic trials.
If your doctor offers to participate in a trial
clinical, will explain the purpose, process,
the expected benefits, risks, and you
will be given an information leaflet.
Participate in a trial assumes that you give to the
prior consent in writing.

often carried out, notably to search for "deep," attacks

that which cannot be seen during the clinical examination. In

general rule, the doctor ordered a chest x-ray and a scan

neck, chest, abdomen and pelvis. Emission tomography

pet (PET-scan) is a review also practiced to detect

all active households in the disease. Blood tests are also

including made to measure disease activity markers.

Depending on each patient's health status, other tests may be

requested in order to complete the assessment.

The treatment

In most cases, the treatment of Hodgkin lymphoma is based on

chemotherapy, combining several drugs, followed or not a

radiotherapy. The type of chemotherapy and radiotherapy, as well as the

duration of each of these treatments are determined according to the stage

the disease and its risk of development. Most of the treatments are

administered in day hospital, i.e. without it being necessary to sleep

at the hospital. At the present time, with the available treatments, it is possible

to get a complete and durable remission followed by a healing in most of

80% of people with Hodgkin's disease.

In case of relapse of the disease, treatment must be implemented.

It is usually based on the administration of chemotherapy. It is thus

possible to get a new remission from lymphoma. In order to increase

the chances of successful treatment in case of relapse, it could be envisaged to

use of a stem cell transplant followed intensive chemotherapy.

High-dose chemotherapy has the effect to destroy most if not

all cancer cells. The disadvantage of this treatment is that it results in

a very significant reduction in the number of normal blood cells

(so-called an Aplasia). The body ends up helpless

infections. To limit the duration of the Aplasia and make sure that the

blood cells are replenished quickly, we practice an autograft. This

is to take the patient, before intensive chemotherapy, the cells

strains able to produce all the normal cells of the blood. These

are collected during an Apheresis, a process that is to

the blood through a device that retains only the cells stem, then they

are frozen. Once the intensive treatment is finished, they are thawed and

fed back to the patient in order to renew the population of blood cells. This

procedure requires a hospital stay of several weeks.

The follow-up

When the disease remission is obtained after a treatment, it is essential

a specialist physician at regular intervals. This monitoring includes

usually tests blood and imaging, as well as a clinical examination

complete the consultation. This allows to control the stability of the remission

and, in case of recurrence of the disease, to detect early signs the

relapse. In addition, long-term treatment side effects that can

occur, the doctor may suggest an adequate care of them.

The pace of follow-up is adapted to each patient.