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Q: Could you give me some statistics on Hodgkins Disease - such as how many people have recurrences, when do the recurrences usually take place (how many years after end of treatment), what is the average length of complete remission, what are the cure rates, how many patients end up requiring a bone marrow transplant (average), etc.?
A: Hodgkin's disease is a group of cancers characterized by the presence of a specific type of cell, referred to as the Reed-Sternberg cell. There are two age peaks at which this disease most frequently occurs, one in the 20s and the other in the 50s.The most common presentation of the disease is a painless mass, most commonly in the neck. There may also be other symptoms, such as fever, weight loss, and night sweats. The diagnosis is made by examination of lymph node tissue. The pathologist must distinguish it from other lymphomas and nonmalignant diseases. Patients should undergo a staging evaluation to determine the extent of disease. The staging definitions are as follows: stage 1, one lymph node region involved, stage 2, two lymph node areas on one side of the diaphragm (the breathing muscle separating the chest from abdomen), stage 3, lymph node areas on both sides of the diaphragm, stage 4, disseminated disease with bone marrow or liver involvement. In addition the letter A is used for staging if the patients do not have fever, night sweats, or weight loss, while the letter B is used in case any of these symptoms is present.
Patients with stage 1 or 2A disease are treated with radiation therapy. Overall survival for this stage with this treatment is 90%. Patients with stage 2B are treated with combined radiation therapy and chemotherapy, as well as patients with stage 3A disease. Patients with stages 3B and 4 are treated with aggressive chemotherapy. Chemotherapy choices include MOPP (nitrogen mustard, vincristine, oncovin, procarbazine, and prednisone), or ABVD (adriamycine, bleomycin, vinblastine, and dactinomycine), alternating MOPP and ABVD treatments, or treatments combining these drugs. Approximately 2/3 of patients with advanced disease can be cured. The majority of relapses occur within 5 years. Complete response rates occurs in patients who received no prior chemotherapy or whose relapses occurred more than 1 year after completion of previous therapy. Patients who relapse within a year of their first chemotherapy regimen are candidates for bone marrow transplant.
Updated: 05/31/99
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