Hodgkin's Lymphoma Details
Editor-In-Chief: Dr. Heidi Kussmann, ND, FABNO
Hodgkin’s Lymphoma is a type of blood cancer that accounts for about 1% of new cancer cases annually in the USA, or about 7,000 cases per year. Hodgkin's Lymphoma has two peak ages of incidence - one in the 20s and the second after the age of 50. This type of cancer is one that affects the lymphocytes, a subclass of white blood cells. In 70% of cases it presents as enlarged lymph nodes in the neck. .
- Many of the signaling pathways that promote survival are shared between the EBV-induced proteins, such as EBNA1, LMP1, and LMP2, and other molecules that are upregulated in Reed-Sternberg cells. A key role is played by the presence of constitutive nuclear factor (NF)-kappaB, which is induced by LMP1, as well as by CD30, CD40, tumor necrosis factor (TNF)-alpha, and Notch1 interactions, and results in the upregulation of at least 45 genes including chemokines, cytokines, receptors, apoptotic regulators, intracellular signaling molecules, and transcription factors.
- The other characteristic of classical HL is the presence of an extensive inflammatory infiltrate. Key features of this infiltrate are that it comprises Th2 and T regulatory cells and generally lacks Th1 cells, CD8 cytotoxic T cells, and natural killer (NK) cells. The RS cells appear to induce this infiltrate by the secretion of Th2 type chemokines such as TARC and MDC. The RS cells also produce cytokines that inhibit Th1 responses, as interleukin (IL)-10 and transforming growth factor (TGF)-beta express CD95 ligand, which induces apoptosis of activated Th1 and CD8 T cells. 
Conventional Medical Treatment
- Common oncology interventions include chemotherapy and radiation therapy. Chemotherapy consists of Doxorubicin/Adriamycin, Bleomycin, Vinblastine, Dacarbazine as a primary therapy choice for all stages of Hodgkin's Lymphoma.
- After first line treatment does not achieve a complete response, a salvage regimen is utilised. Also, once a maximum response has been obtained with conventional-dose salvage therapy, a patient gets high-dose chemotherapy with bone marrow transplantation, regardless of how long the initial complete response lasted. Response rates are similar for all salvage regimens. Alkylating agents are used in preparation for high-dose chemotherapy with bone marrow transplantation.
- Casciato DA. Manual of Clinical Oncology 5th ed. Lippincott Williams & Wilkins 2004. Pp 417-457
- Poppema S. Immunobiology and pathophysiology of Hodgkin lymphomas. Hematology Am Soc Hematol Educ Program. 2005:231-8 PMID:16304386.