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What is Hodgkin's Lymphoma? Print E-mail
Written by Mike Cohen   
Tuesday, 20 October 2009
Hodgkin's lymphoma is a cancer of the lymphatic tissue. This includes the lymph nodes, spleen, and bone marrow. The lymphatic system drains fluid from tissue and returns it to the blood. It plays an important role in the body's defense against infection.
What is going on in the body?

Hodgkin's lymphoma is a cancer that develops in a certain type of lymphatic cell. It causes lymphatic organs to become enlarged and spreads to the bone marrow and other tissues. The exact type of lymph cell that becomes cancerous remains controversial. But, when a Reed-Sternberg cell, or a large, unusual white cell, is seen in any tissue or blood specimen, it confirms the diagnosis of Hodgkin's lymphoma.

Sometimes Hodgkin's lymphoma is very slow growing. Other times it can spread quickly. It can restrict itself to one lymph node area. At other times, all lymph nodes, as well as the liver, spleen, and bone marrow, become involved. Hodgkin's lymphoma rarely spreads to the bones, brain, or kidneys.
What are the causes and risks of the disease?

The cause and risks of developing Hodgkin's lymphoma are not known. It might be caused by a virus, possibly the Epstein-Barr virus. A virus or combination of viruses could damage certain susceptible immune cells. This damage may change the genes that are responsible for lymph cell growth and regulation.

Hodgkin's lymphoma may be genetic. It seems to affect people with a higher education and socioeconomic level. People with immunodeficiency disorders, including AIDS, may be at risk. It is also linked to certain unusual infections. It may occur years after a person is cured of leukemia, another type of blood cancer. It is most common in people between the ages of 20 and 30, and again after the age of 50. Most children with Hodgkin's lymphoma are male.
What are the treatments for the disease?

Some of the treatment options for Hodgkin's lymphoma are as follows:
# chemotherapy, which uses chemicals or drugs to kill certain cells
# radiation therapy
# a combination of both radiation and chemotherapy

Bone marrow transplants may be successful for some high-risk people whose lymphoma has recurred despite other treatments. This treatment involves giving the person high doses of chemotherapy, total body radiation, and an infusion of bone marrow from another person.

Hodgkin's lymphoma that recurs after radiation is often treated successfully with chemotherapy. If the spleen is involved, it may be removed with surgery.
What are the side effects of the treatments?

Radiation therapy can cause these side effects:
# irritation of the esophagus or intestines
# lymphedema, which occurs when a fluid called lymph builds up and causes swelling of an extremity
# nausea and vomiting
# risk for other cancers
# skin burning
# temporarily lowered blood counts

Chemotherapy can cause side effects such as the following:
# abnormal bleeding
# fatigue
# hair loss
# increased chance of needing blood transfusions
# lowered blood cell counts
# mouth and lip sores
# nausea and vomiting
# risk of infections
# stomach upset

These treatments also can cause damage to the following areas:
# bone marrow
# heart
# kidneys
# liver
# lungs
# peripheral nerves

A combination of radiation and chemotherapy can cause more severe side effects. High-dose chemotherapy and bone marrow transplantation are highly toxic and risky treatments. Sometimes the transplanted immune system attacks the person's normal cells and tissue. There can be mild problems with skin rash and diarrhea. There can also be major organ failure, causing death.
>What happens after treatment for the disease?

After treatment, people are managed for chronic side effects. They are also monitored for recurrence of their disease. People who have had their spleen removed need to be vaccinated to prevent certain bacterial infections. Recommended vaccines include those for pneumonia, Haemophilus influenza, and, sometimes, meningococcal meningitis.
How is the disease monitored?

Hodgkin's disease sometimes recurs. For this reason, the healthcare provider will monitor a person for several years by doing the following:
# blood chemistry tests
# bone marrow biopsies
# bone scans
# CAT scans
# complete blood counts
# physical exams
# X-rays

Any new or worsening symptoms should be reported to the healthcare provider.


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