lymphoma cancer | Treatment of Hodgkin's lymphoma in Adults General information on Hodgkin's lymphoma in adults

Treatment of Hodgkin's lymphoma in Adults
General information on Hodgkin's lymphoma in adults

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Important points
Hodgkin's lymphoma in adults is a disease that forms malignant (cancerous) cells in the lymphatic system.
There are two main types of Hodgkin lymphoma: Classic and nodular with lymphocytic predominance.
Age, sex, and Epstein-Barr virus infection may affect the risk of Hodgkin's lymphoma in adults.
Signs of Hodgkin's lymphoma in adults include swollen lymph nodes, fever, night sweats, and weight loss.
Tests to examine the lymph nodes are used to detect (find) and diagnose Hodgkin's lymphoma in adults.
Certain factors affect the prognosis (possibility of recovery) and treatment options.
Hodgkin's lymphoma in adults is a disease that forms malignant (cancerous) cells in the lymphatic system.
Adult Hodgkin's lymphoma is a type of cancer that occurs in the lymphatic system, which forms part of the body's immune system. The immune system protects the body from foreign substances, infections and illnesses. The lymphatic system consists of the following:

Lymph: colorless and aqueous fluid that transports white blood cells called lymphocytes through the lymphatic system. Lymphocytes protect the body from infection and tumor growth.

Lymphatic vessels: A network of thin tubes that collect lymph from different parts of the body and return it to the bloodstream.

Lymph nodes: small, bean-shaped structures that filter lymph and store white blood cells that help fight infections and diseases. Lymph nodes are located along the network of lymphatic vessels throughout the body. They are present in groups in the neck, armpits, abdomen, pelvis, and groin.

Spleen: An organ that develops lymphocytes, filters blood, stores blood cells, and destroys old blood cell. It is located on the left side of the abdomen, near the stomach.

Thymus: an organ in which lymphocytes grow and multiply. The thymus is in the chest, behind the sternum.

Tonsils: Two small masses of lymphatic tissue in the back of the throat. Tonsils develop lymphocytes.

Bone marrow: soft, spongy tissue in the center of large bones. It produces white blood cells, red blood cells and platelets.

Lymphatic AMPLIARSistema; The drawing shows the lymphatic vessels and lymphatic organs, including the lymph nodes, the tonsils, the thymus, the spleen, and the bone marrow. A box shows the inner structure of a lymph node and the attached lymphatic vessels, with arrows indicating how the lymph (a clear fluid) circulates in and out of the lymph node. Another box shows an expanded view of the bone marrow with blood cells.

Anatomy of the lymphatic system; Lymph vessels and lymphatic organs, including lymph nodes, tonsils, thymus, spleen, and bone marrow are shown. The lymph (a clear fluid) and lymphocytes move through the lymphatic vessels to the lymph nodes, where lymphocytes destroy substances that are harmful. The lymph enters the blood through a large vein near the heart.

Lymphatic tissue is also found in other parts of the body such as the stomach, thyroid gland, brain, and skin. Cancer can spread to the liver and lungs.

Lymphomas are divided into two general types: Hodgkin's lymphoma and non-Hodgkin's lymphoma. This summary refers to the treatment of Hodgkin's lymphoma in adults. (For more information, see the PDQ treatment of adult non-Hodgkin's lymphoma.)

Hodgkin's lymphoma can occur in both adults and children. Treatment for adults is different from treatment for children. It is also manifested in patients with acquired immunodeficiency syndrome (AIDS); These patients need special treatment.

For more information, see the following PDQ summaries:

Treatment of childhood Hodgkin's lymphoma

Treatment of AIDS-related lymphoma

Hodgkin's lymphoma in pregnant women is the same disease as that of non-pregnant women of procreation age. However, treatment is different for pregnant women. This summary includes information on the treatment of Hodgkin's lymphoma during pregnancy.

There are two main types of Hodgkin lymphoma: Classic and nodular with lymphocytic predominance.

Most Hodgkin's lymphomas are of a classic type. The classic type is subdivided into the following subtypes:

Hodgkin's lymphoma with nodular sclerosis.

Hodgkin's lymphoma with mixed cellularity.

Hodgkin's lymphoma with lymphocytic depletion.

Hodgkin's lymphoma with classic lymphocytic predominance.

Age, sex, and Epstein-Barr virus infection may affect the risk of Hodgkin's lymphoma in adults.

Anything that increases the likelihood of having a disease is called a risk factor. The presence of a risk factor does not mean that you will become ill with cancer; But the absence of risk factors does not mean that you will not be sick with cancer. Talk to your doctor if you think you are at risk. The risk factors for Hodgkin's lymphoma in adults are as follows:

Be a young or mature adult.

Be a boy.

Be infected with the Epstein-Barr virus.

Having a first-grade relative (father, brother, or sister) with Hodgkin's lymphoma.

Pregnancy is not a risk factor for Hodgkin's lymphoma.

Signs of Hodgkin's lymphoma in adults include swollen lymph nodes, fever, night sweats, and weight loss.

These and other signs and symptoms may be caused by Hodgkin's lymphoma in adults or other conditions. Talk to your doctor if any of the following problems do not go away:

Painless inflammation of the lymph nodes in the neck, armpits, or groin.

Fever without known reason.

Excessive night sweats.

Weight loss for no known reason.

Itchy skin.

Feeling very tired.

Tests to examine the lymph nodes are used to detect (find) and diagnose Hodgkin's lymphoma in adults.

The following tests and procedures may be used:

Physical examination and background: examination of the body to check general health signs, including signs of disease, such as masses or anything else that seems abnormal. The medical records of diseases and previous treatments are also taken.

Complete blood count (RSC): A procedure by which a blood sample is taken to verify the following elements:

The number of red blood cells, white blood cells, and platelets.

The amount of hemoglobin (the oxygen-carrying protein) in the red blood cells.

The part of the sample consisting of red blood cells.

Complete Blood AMPLIARRecuento (RSC); The left panel shows the blood when it is extracted from a vein in the anterior part of the elbow by a tube connected to a syringe; The right-hand panel shows a laboratory test tube with separate blood cells in layers: plasma, white blood cells, platelets, and red blood cells.

Complete blood count (RSC). Blood is extracted by entering a needle into a vein and the blood is allowed to flow into a tube. The blood sample is sent to the laboratory and red blood cells, white blood cells, and platelets are counted. CSR is used to examine, diagnose, and monitor many different conditions.

Biochemical studies of blood: Tests for examining a blood sample to measure the amount of certain substances that the organs of the body release in the blood. An abnormal amount (higher or lower than normal) of a substance is usually a sign of disease.

Sedimentation rate: A procedure in which a blood sample is taken and the speed with which the red blood cells settles at the bottom of the test tube is analyzed. The sedimentation rate is a measure to determine how much inflammation is in the body. A higher than normal sedimentation rate may be a sign of lymphoma or other condition. It is also known as VSG globular sedimentation rate.

Lymph node biopsy: Total or partial removal of a lymph node. One of the following types of biopsy may be performed:

Excisional biopsy: Complete removal of a lymph node.

Incisional biopsy: Removal of a part of a lymph node.

Coarse-needle biopsy: Removal of a part of a lymph node by a wide needle.

A pathologist observes the tissue under the microscope in search of cancerous cells, especially Reed-Sternberg cells. Reed-Sternberg cells are common in the case of classical Hodgkin lymphoma.

Reed-Sternberg AMPLIARCélula; The picture shows the normal lymphocytes compared to a Reed-Sternberg cell.

Reed-Sternberg cell. Reed-Sternberg cells are large, abnormal lymphocytes that can contain more than one nucleus. These cells are found in Hodgkin's lymphoma.

The following test can be performed with the tissue that was extracted:

Immunophenotyping: A laboratory test that identifies the cells according to the types of antigens or markers present on the cell surface. This test is used to diagnose specific types of lymphoma by comparing cancer cells with normal immune system cells.

Certain factors affect the prognosis (possibility of recovery) and treatment options.

The prognosis (possibility of recovery) and the treatment options depend on the following aspects:

The signs and symptoms of the patient.

The cancer Stadium.

The type of Hodgkin lymphoma.

The results of the blood tests.

The age, sex and general health of the patient.

If the cancer is relapsing or progressive.

In the case of Hodgkin's lymphoma during pregnancy, treatment options also depend on the following aspects:

The patient's wishes.

The age of the fetus.

Hodgkin's lymphoma in adults can usually be cured if it is detected and treated early.

Stages of Hodgkin's lymphoma in adults

Important points

After Hodgkin's lymphoma is diagnosed in adults, tests are performed to determine whether cancer cells have spread within the lymphatic system or to other parts of the body.

The cancer spreads in the body in three ways.

The stages of Hodgkin's lymphoma in adults may include forms A, B, E and S.

The following stages are used for Hodgkin's lymphoma in adults:

Stadium I

Stage II

Stage III

Stage IV

Adult Hodgkin's lymphoma can be grouped for treatment purposes as follows:

Early favorable

Early unfavorably

Advanced

After Hodgkin's lymphoma is diagnosed in adults, tests are performed to determine whether cancer cells have spread within the lymphatic system or to other parts of the body.

The process used to determine whether the cancer is spread within the lymphatic system or to other parts of the body is called staging. The information obtained from the staging process determines the stage of the disease. It is important to have this information in order to plan for the best treatment. The following tests and procedures may be used in the staging process:

Computed tomography (CT): A procedure for taking a series of detailed images of the inside of the body from different angles. Images are created with a computer connected to an X-ray machine. A dye is injected into a vein or ingested, so that organs or tissues are more clearly highlighted. This procedure is also called computerized tomography, computed axial tomography (TAC) or CT scan. In the case of adult Hodgkin's lymphoma, CT scans of the neck, chest, abdomen, and pelvis are done.

Positron and computerized tomography (PET-TC): A procedure for combining the images obtained using a positron emission tomography (TEP) and a computed tomography (CT). Pet and CT scans are performed at the same time with the same machine. The combination of the images of both tomographies allows to obtain a more detailed image than that which would be achieved with each procedure separately. A positron emission tomography is a procedure used to find cells of a malignant tumor in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scan rotates around the body and creates an image of the places on the body that use glucose. Malignant tumor cells look brighter in the image because they are more active and absorb more glucose than normal cells.

Bone marrow aspiration and biopsy: removal of a bone marrow sample, blood, and a small piece of bone by introducing a hollow needle into the hip bone or sternum. A pathologist looks at the bone marrow, blood, and bone under a microscope to check for signs of cancer.

Bone marrow AMPLIARAspiración and biopsy;  The drawing shows a patient lying face down on a stretcher and a needle for bone marrow inserted into the hip bone. The box shows the bone marrow needle that is inserted through the skin to the bone marrow of the hip bone.  

Bone marrow aspiration and biopsy. After a small area of the skin is numbed, a bone marrow needle is inserted into the patient's hip bone. Blood, bone, and bone marrow samples are extracted for examination under a microscope.

For pregnant women with Hodgkin lymphoma, staging tests that protect the fetus from the harmful effects of radiation are used. These tests include the following:

Magnetic resonance imaging (MRI): A procedure for using a magnet, radio waves, and a computer in order to create a series of detailed images of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (IRMN).

Ultrasound: A procedure for rebounding high-energy (ultrasonic) sound waves in internal tissues or organs in order to produce echoes. The echoes form an image of the tissues of the body called the Ecograma.

The cancer spreads in the body in three ways.

The stages of Hodgkin's lymphoma in adults may include forms A, B, E and S.

Hodgkin's lymphoma in adults can be described as follows:

A. The patient does not have symptoms B (fever, weight loss or night sweats).

B. The patient has symptoms B.

E. Cancer is found in an organ or tissue that is not part of the lymphatic system, but may be near an affected area of the lymphatic system.

S. The cancer is found in the spleen.

The following stages are used for Hodgkin's lymphoma in adults:

Stadium I

Hodgkin's AMPLIARLinfoma in stage I adults; The drawing shows a cancer in a group of lymph nodes above the diaphragm. In a box, you can see a lymph node with a lymphatic vessel, an artery, and a vein. In the lymph node, lymphoma cells that contain cancer can be seen. 

Hodgkin's lymphoma in stage I adults. Cancer is found in one or more lymph nodes in a group of lymph nodes. In the IE Stadium (not shown), the cancer is found in an area or organ outside the lymph nodes.

Stadium I is divided into stadium I and IE Stadium.

Stadium I. The cancer is found in the following sites of the lymphatic system:

One or more lymph nodes in a group of lymph nodes.

The Ring of Waldeyer.

The thymus.

The spleen.

IE Stadium. Cancer is found outside the lymphatic system, in an organ or area.

Stage II

Stage II is divided into stage II and IIE Stadium.

Stage II. The cancer is found in two or more groups of lymph nodes above or below the diaphragm (the thin muscle under the lungs that helps to breathe and separates the thorax from the abdomen).

Hodgkin's AMPLIARLinfoma in stage II adults; The drawing shows cancer in a group of lymph nodes above and below the diaphragm. In a box, you can see a lymph node with a lymphatic vessel, an artery, and a vein. In the lymph node, lymphoma cells that contain cancer can be seen.

Hodgkin's lymphoma in stage II adults. The cancer is found in two or more groups of lymph nodes, and both are either above (a) or below (b) of the diaphragm.

IIE Stadium. Cancer is found in one or more lymph node groups above or below the diaphragm, and outside the lymph nodes of a nearby organ or area.

AMPLIARLinfoma of Hodgkin in adults at Estadio IIE; The drawing shows cancer in a group of lymph nodes above the diaphragm and in the left lung. In a box, you can see a lymph node with a lymphatic vessel, an artery, and a vein. Lymphoma cells that contain cancer can be seen in the lymph node.

Hodgkin's lymphoma in adults at stage IIE. The cancer is found in one or more lymph node groups above or below the diaphragm, and in an area or organ close to the lymph nodes.

Stage III

Hodgkin's AMPLIARLinfoma in stage III adults; The drawing shows cancer in groups of lymph nodes above and below the diaphragm, in the left lung and in the spleen. In a box, you can see a lymph node with a lymphatic vessel, an artery, and a vein. In the lymph node, lymphoma cells that contain cancer can be seen.

Hodgkin's lymphoma in stage III adults. Cancer is found in one or more lymph node groups, above and below the diaphragm (a). In the IIIE stadium, the cancer is found in groups of lymph nodes above and below the diaphragm, and in an area or organ close to the lymph nodes (b). In the IIIS Stadium, cancer is found in lymph node groups above and below the diaphragm (a), and in the Spleen (c). In the IIIS Stadium plus the E-stage, the cancer is found in lymph node groups above and below the diaphragm, in an area or organ close to the lymph nodes (b), and in the Spleen (c).

Stage III is divided into stage III, IIIe Stadium, IIIS Stadium and IIIe Stadium, S.

Stage III. The cancer is found in groups of lymph nodes above and below the diaphragm (a thin muscle under the lungs that helps breathing and separates the thorax from the abdomen).

IIIE Stadium. The cancer is found in groups of lymph nodes above and below the diaphragm, and outside the lymph nodes of a nearby organ or area.

IIIS Stadium. The cancer is found in groups of lymph nodes above and below the diaphragm, and in the spleen.

Estadio IIIE, S. The cancer is found in groups of lymph nodes above and below the diaphragm, outside the lymph nodes of a nearby organ or area, and in the spleen.

Stage IV

Hodgkin's AMPLIARLinfoma in stage IV adults; The picture shows a cancer in the liver, the left lung, and a group of lymph nodes below the diaphragm. You can also see the brain and the pleura. In a box, you can see in the foreground the cancer that spreads through the lymph nodes and lymphatic vessels to other parts of the body. The lymphoma cells that contain cancer can be seen inside a lymph node. In another box you can see cancerous cells in the bone marrow.

Hodgkin's lymphoma in stage IV adults. Cancer is found outside the lymph nodes through one or more organs (a); or outside the lymph nodes in an organ and spread to lymph nodes far away from that organ (b); Or it's in the lung, the liver, or the bone marrow.

In stage IV, cancer:

It is found outside the lymph nodes in the entirety of one or more organs, and may be in the lymph nodes near those organs; Or

It is found outside the lymph nodes of an organ and is spread to areas far removed from that organ; Or

It is found in the lung, liver, bone marrow, or cerebrospinal fluid (CSF). Cancer is not spread to the lung, liver, bone marrow, or CSF from nearby areas.

Adult Hodgkin's lymphoma can be grouped for treatment purposes as follows:

Early favorable

Early Hodgkin's lymphoma favorable in adults corresponds to stage I or stage II, without risk factors.

Early unfavorably

Unfavourable early Hodgkin lymphoma in adults corresponds to stage I or stage II, with one or more of the following risk factors:

A Tumor in the thorax that measures more than 1/3 of the chest width or at least 10 centimeters.

Cancer in a different organ of the lymph nodes.

High sedimentation rate (in a blood sample, red blood cells are seated at the bottom of the test tube faster than normal).

Three or more lymph nodes with cancer.

Symptoms such as fever, weight loss, or night sweats

Advanced

Advanced Hodgkin's lymphoma in adults includes some or all of the following risk factors:

Be a boy.

Be 45 years old or older.

Have stage IV disease.

Have a low concentration of albumin (protein) in the blood (below 4).

Have a low hemoglobin concentration (below 10.5).

Have a high white blood cell count (15,000 or more).

Have a low lymphocyte count (less than 600 or less than 8% of the white blood cell concentration)

Recurrent Hodgkin's lymphoma in adults

Recurrent Hodgkin's lymphoma in adults is cancer that has recurred (returned) after being treated. Cancer can return to the lymphatic system or other parts of the body.

General aspects of Treatment options

Important points

There are different types of treatment for Hodgkin's lymphoma patients in adults.

Treatment of patients with Hodgkin's lymphoma should be planned by a team of health care providers specializing in the treatment of lymphomas.

Sometimes treatment for Hodgkin's lymphoma in adults causes side effects.

Three standard treatment types are used:

Chemotherapy

Radiotherapy

Surgery

For pregnant patients with Hodgkin lymphoma, treatment options also include the following procedures:

Cautious wait

Steroid therapy

New types of treatment in clinical trials are being tested.

Chemotherapy and radiotherapy with stem cell transplantation

Monoclonal antibody Therapy

Patients might consider participating in a clinical trial.

Patients may enter clinical trials before, during, or after starting their cancer treatment.

Sometimes follow-up tests are needed

There are different types of treatment for Hodgkin's lymphoma patients in adults.

Different types of treatment are available for patients with Hodgkin's lymphoma in adults. Some treatments are standard (the treatment currently used) and others are in clinical trial evaluation. A clinical trial of treatment is a research study that seeks to improve current treatments or obtain information on new treatments for cancer patients. When clinical trials show that a new treatment is better than standard treatment, new treatment can be converted to standard treatment. Patients should consider participating in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

For pregnant women with Hodgkin lymphoma, treatment is carefully chosen to protect the fetus. Decisions about treatment are based on the mother's wishes, the stage of Hodgkin's lymphoma, and the age of the fetus. The treatment plan may change as signs and symptoms, cancer, and pregnancy change. Choosing the most appropriate treatment is a decision that, in an ideal way, engages the patient, family and health care team.

Treatment of patients with Hodgkin's lymphoma should be planned by a team of health care providers specializing in the treatment of lymphomas.

The treatment will be supervised by a medical oncologist, a medical doctor who specializes in the treatment of cancer. The medical oncologist may send the patient to other health care providers with experience and expertise in the treatment of Hodgkin's lymphoma in adults and specialize in certain fields of medicine. These are the following specialists:

Neurosurgeon.

Neurologist.

Rehabilitation Specialist.

Radiation oncologist.

Endocrinologist.

Hematologist.

Other oncology specialists.

Sometimes treatment for Hodgkin's lymphoma in adults causes side effects.

For more information on the side effects of cancer treatment, see our side effects page.

The side effects of cancer treatment that appear after treatment and continue for months or years are called late effects. Treatment with chemotherapy or radiotherapy of Hodgkin's lymphoma may increase the risk of second cancers and other health problems for many months or years after treatment. These late effects depend on the type of treatment and the age of the patient when treated, and may include the following conditions:

Acute myelogenous leukemia.

Breast cancer, bone, cervix, gastrointestinal tube, head and neck, lungs, soft tissue, and thyroid.

Heart, lung, and thyroid disease.

Avascular Necrosis of Bone (death of bone cells due to lack of blood flow)

Herpes zoster (shingles) or severe infection.

Depression and fatigue.

Sterility.

Hypogonadism (low testosterone and estrogen concentrations)

It is important for the long-term health of patients treated by Hodgkin's lymphoma to be regularly monitored by expert physicians in the detection and treatment of late effects.

Three standard treatment types are used:

Chemotherapy

Chemotherapy is a cancer treatment in which drugs are used to stop the formation of cancer cells, either by destruction or by preventing multiplication. When chemotherapy is taken by mouth or injected into a vein or muscle, medications enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ or body cavity such as the abdomen, the medications primarily affect cancer cells in those areas (regional chemotherapy). The form of chemotherapy administration depends on the type and stage of the cancer being treated. Combined chemotherapy is treatment with two or more anti-cancer drugs.

When dealing with chemotherapy to a patient with Hodgkin's lymphoma who is pregnant, it is not possible to protect the fetus from exposure to it. Some chemotherapy regimens may cause congenital malformations in the first trimester. Vinblastine is a cancer drug that has not been related to congenital malformations when given in the second half of pregnancy.

For more information in English, see the drug approved for Hodgkin Lymphoma (medication for Hodgkin's lymphoma) link.

Radiotherapy

Radiotherapy is a cancer treatment for which high-energy X-rays or other types of radiation are used to destroy cancer cells or prevent them from growing. There are two types of radiation therapy:

External radiotherapy: type of radiotherapy for which a machine is used to send radiation to the cancer from the outside of the body.

Internal radiotherapy: type of radiotherapy for which a radioactive substance sealed in needles, seeds, wires or catheters is used, which are placed directly in or near the cancer.

How radiation therapy is given depends on the type and stage of the cancer being treated. External radiotherapy is used to treat Hodgkin's lymphoma in adults.

Radiation therapy should be postponed until after delivery in the case of a woman with Hodgkin's lymphoma who is pregnant to avoid any risk to the fetus. If it is necessary to administer the treatment immediately, the woman may decide to continue with the pregnancy and receive radiation therapy. However, the lead used to protect the fetus may not protect it from scattered radiation that may possibly cause cancer in the future.

Surgery

Laparotomy is a surgical procedure in which an incision (cut) is made on the wall of the abdomen to observe the inside of the abdomen and determine if there are signs of disease. The size of the incision depends on the reason why the laparotomy is performed. Sometimes organs are removed or tissue samples are taken to observe them under a microscope and check for signs of disease. If cancer is found, tissue or organ is removed during laparotomy.

For pregnant patients with Hodgkin lymphoma, treatment options also include the following procedures:

Cautious wait

Cautious waiting is careful monitoring of the patient's condition without administering any treatment until signs or symptoms are present, or they change. Childbirth may be induced when the fetus is between 32 and 36 weeks of age, so that the mother can begin treatment.

Steroid therapy

Steroids are hormones that the adrenal glands and reproductive organs naturally develop in the body. Some types of steroids occur in the lab. Certain steroid medications have been found to help make chemotherapy more effective and disrupt cancer cell growth. Steroids can also help the fetus's lungs develop faster than normal. This aspect is important when childbirth is induced early.

For more information in English, see the drug approved for Hodgkin Lymphoma (medication for Hodgkin's lymphoma) link.

New types of treatment in clinical trials are being tested.

In this section of the summary, reference is made to treatments in clinical trials, but all the new treatments that are being considered may not be mentioned. For more information on clinical trials, see the NCI website.

Chemotherapy and radiotherapy with stem cell transplantation

High-dose chemotherapy and radiotherapy with stem cell transplantation are ways to administer high doses of chemotherapy and radiotherapy, and to replace the blood-forming cells destroyed by cancer treatment. Stem cells (immature blood cells) are extracted from the patient's blood or bone marrow or from a donor, and are frozen and stored. After the chemotherapy is complete, the stored stem cells are thawed and re-injected into the patient by an infusion. These reinjected stem cells grow (and restore) the body's blood cells. The use of low doses of chemotherapy and radiotherapy with stem cell transplantation is also under study.

Monoclonal antibody Therapy

Monoclonal antibody therapy is a cancer treatment for which laboratory-produced antibodies are used from a single type of immune system cell. These antibodies can identify substances in cancer cells or normal substances that can help the growth of cancer cells. Antibodies adhere to these substances and destroy cancer cells, impede their growth or prevent spread. Monoclonal antibodies are administered by infusion. They can be used alone or to carry drugs, toxins or radioactive material directly to cancer cells.

Patients might consider participating in a clinical trial.

For some patients, the best treatment choice could be a clinical trial. Clinical trials are part of the cancer research process. Clinical trials are conducted to determine whether new treatments for cancer are harmless (safe) and effective, or better than standard treatment.

Many of the current standard treatments are based on previous clinical trials. Patients who participate in a clinical trial receive standard treatment or are the first to receive the new treatment.

Patients participating in clinical trials also help to improve the way cancer will be treated in the future. Although clinical trials do not always lead to effective treatments, they often answer important questions and help advance research.

Patients may enter clinical trials before, during, or after starting their cancer treatment.

In some clinical trials only patients who have not yet received treatment are accepted. In other trials, therapies are tested in cancer patients who did not improve. There are also clinical trials in which new ways of preventing cancer from recidive (return) or reducing the side effects of cancer treatment are tested.

Clinical trials are conducted in many parts of the country. The information in English on clinical trials sponsored by the National Cancer Institute (NCI) is available on the clinical Trials Search Web site. For information in English on clinical trials sponsored by other organizations.

Sometimes follow-up tests are needed
Some tests may be repeated to diagnose the cancer or to determine the stage of the cancer. Other tests are repeated to ensure that the treatment is effective. Decisions about following, changing, or suspending treatment may be based on the results of these tests.

Some of the tests are repeated every so long after the treatment is complete. The results of these tests show whether the condition changed or whether the cancer has recurred (returned). These tests are also called follow-up tests or checkups.

Treatment options for Hodgkin's lymphoma in adults
For information on the treatments listed below, see the section on general aspects of treatment options.

Hodgkin's lymphoma in favorable initial state
Treatment of Hodgkin's lymphoma in favorable initial state includes the following procedures:

Combined chemotherapy.
Chemotherapy combined with radiation therapy to the parts of the body that have cancer.
Radiotherapy alone directed to parts of the body that have cancer or to the mantle field (neck, chest, and armpits).
Perform an English search for NCI-sponsored cancer clinical trials that accept patients at this time. Search by type of cancer, patient's age, and place of trial. See also general clinical trial information.Hodgkin's lymphoma in unfavorable initial state

The treatment of Hodgkin's lymphoma in unfavorable initial state includes the following procedures:

Combination chemotherapy.

Chemotherapy combined with radiation therapy to the parts of the body that have cancer.

Search in English of clinical cancer trials sponsored by NCI that accept patients at this time. Search by type of cancer, the patient's age and place of the trial. See also general information on clinical trials.

Hodgkin's lymphoma advanced

The treatment of Hodgkin's lymphoma at advanced stage includes the following:

Combination chemotherapy.

Search in English of clinical cancer trials sponsored by NCI that accept patients at this time. Search by type of cancer, the patient's age and place of the trial. See also general information on clinical trials.

Recurrent adult Hodgkin Lymphoma

Treatment of relapsed Hodgkin's lymphoma include the following:

Combination chemotherapy.

Combination chemotherapy followed by high-dose chemotherapy and stem cells, radiation therapy with or without transplant.

Chemotherapy combined with radiotherapy to other parts of the body with cancer in patients over 60 years old.

Radiotherapy, chemotherapy with or without this.

Chemotherapy as palliative therapy to relieve symptoms and improve quality of life.

Participation in a clinical trial of high-dose chemotherapy and stem cell transplant.

Participation in a clinical trial of low-dose chemotherapy and radiotherapy, followed by a stem cell transplant.

Participation in a clinical trial of a monoclonal antibody.

Participation in a clinical trial with chemotherapy.

Search in English of clinical cancer trials sponsored by NCI that accept patients at this time. Search by type of cancer, the patient's age and place of the trial. See also general information on clinical trials.

Treatment options for Hodgkin's Lymphoma during pregnancy

For information about treatments that are presented below, see the section on general aspects of treatment options.

Hodgkin's Lymphoma during the first trimester of pregnancy

When Hodgkin's lymphoma diagnosed in the first trimester of pregnancy, it does not mean that necessarily be advised the woman to interrupt the pregnancy. Each treatment a woman depends on stage of lymphoma, the speed with which it is growing and your wishes. For women who choose to continue with the pregnancy, the treatment of Hodgkin's Lymphoma during the first trimester of pregnancy includes the following procedures:

Be cautious when cancer is above the diaphragm, and grows slowly. Labor can be induced when the fetus has between 32 and 36 weeks of age; so the mother can begin treatment.

Radiation above the diaphragm. (Used a lead shielding to protect the fetus from radiation as possible.)

Systemic chemotherapy with one or more medications.

Hodgkin's Lymphoma during the second half of pregnancy

When diagnosed Hodgkin's lymphoma in the second half of pregnancy, the majority of patients may delay treatment until the birth of the baby. The treatment of Hodgkin's Lymphoma during the second trimester of pregnancy includes the following procedures:

Be cautious, with plans to induce the birth when the fetus will be between 32 and 36 weeks old.

Systemic chemotherapy with one or more medications.

Steroid therapy.

Radiotherapy to relieve breathing problems caused by a large tumor in the chest.

Additional information about Hodgkin's lymphoma in adults

For more information about Hodgkin's lymphoma in adults the National Cancer Institute, see the following link:

Hodgkin Lymphoma home page

The information presented below only available in English:

Drugs Approved for Hodgkin Lymphoma (Hodgkin's lymphoma approved drugs)

For more information about cancer in general and other resources available at the National Cancer Institute, see the following links:

Cancer

Staging

Chemotherapy and you: support for people with cancer

Radiation therapy and you: support for people with cancer

How to cope with cancer

Questions for the doctor

The information presented below only available in English:

For Survivors and Caregivers (information for survivors/persons responsible for the care of the patient/patient advocates)

Information on this PDQ summary

Information about the PDQ

The Physician Data Query (PDQ) is the comprehensive database of the National Cancer Institute (NCI). The PDQ database contains summaries of the latest published information on prevention, detection, genetics, treatment, support, and complementary and alternative medicine cancer-related health care. Most of the summaries are written in two versions. Versions for health professionals provides detailed information on technical language. Versions for patients are presented in a language that is easy to understand, that it is not technical. Both versions contain information about the cancer that is accurate and up-to-date. You can also see these abstracts in English.

PDQ is one of the services of the NCI. NCI belongs to the national institutes of health (NIH). The NIH are the center of biomedical research of the federal Government. The PDQ summaries are based on an independent analysis of the medical literature. They do not constitute the NCI and NIH policy statements.

Purpose of this summary

This summary of the PDQ cancer contains up-to-date information on the treatment of Hodgkin's lymphoma in adults. The purpose is to inform and help patients, families and caregivers to care for patients. It does not provide guidelines or formal recommendations for decision-making related to health care.

Reviewers and updates

Editorial boards draw up summaries of the PDQ cancer information and update them. These tips are integrated by experts in the treatment of cancer and other specialties related to this disease. The summaries are reviewed regularly and modified if new information arises. The date of update at the bottom of each summary indicates when the most recent change was made.

The information in this summary for patients is based on the version for health professionals, that the editorial board of the PDQ adult treatment reviewed regularly and updated as necessary.

Information about clinical trials
A clinical trial is a study to answer a scientific question; for example, if a treatment is better than another. The tests are based on previous studies and what is learned in the laboratory. Each trial answers certain scientific questions to find new and better ways to help cancer patients. During treatment clinical trials, is collected information on the effects of a new treatment and its effectiveness. If a clinical trial shows that a new treatment is better that standard treatment, the new treatment may become "estándar". " Patients may consider participating in a clinical trial. Some clinical trials accept only patients that not yet started treatment.

The list of clinical trials of the PDQ is available from the NCI Web site. Also listed in PDQ data for many medical specialists in cancer who participate in clinical trials. For more information, call the Cancer information service at the 1-800-422-6237 (1-800-4-CANCER).

Permissions for the use of this summary
PDQ (Physician Data Query) is a registered trademark. The free use of the text of the documents of the PDQ is authorised. However, we can identify as a summary of information about the PDQ from NCI cancer, except that reproduces in its entirety and is updated regularly. On the other hand, will allow an author to write a sentence like "in the PDQ summary of NCI's information on breast cancer prevention are described, in brief, the following risks: [insert fragment of the indictment]".

It is suggested to quote the references of this summary of the PDQ in the following way:

The images in this summary are reproduced with the permission of the author, artist or Publisher for exclusive use in the PDQ summaries. The use of images outside of the PDQ requires the authorization of the owner, to the National Cancer Institute can not grant. For more information about the use of illustrations of this summary or other cancer-related images, see Visuals Online, a collection of more than 2000 scientific images.

The disclaimer clause
Information in these summaries should not base any decision on refunds of insurance. For more information about insurance coverage, refer to available in Spanish/NCI cancer care management.