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Hodgkin lymphoma: 2014 update on diagnosis, risk-stratification, and management.
[hodgkin lymphoma, classical]
Hodgkin
lymphoma
(
HL
)
is
an
uncommon
B-
cell
lymphoid
malignancy
affecting
9
,
200
new
patients
annually
and
representing
approximately
11
.
5
%
of
all
lymphomas
in
the
United
States
.
HL
is
composed
of
two
distinct
disease
entities
;
the
more
commonly
diagnosed
classical
HL
and
the
rare
nodular
lymphocyte-predominant
HL
.
Nodular
sclerosis
,
mixed
cellularity
,
lymphocyte
depletion
,
and
lymphocyte-rich
HL
are
subgroups
under
the
designation
of
classical
HL
.
An
accurate
assessment
of
the
stage
of
disease
in
patients
with
HL
is
critical
for
the
selection
of
the
appropriate
therapy
.
Prognostic
models
that
identify
patients
at
low
or
high
risk
for
recurrence
,
as
well
as
the
response
to
therapy
as
determined
by
positron
emission
tomography
scan
,
are
used
to
optimize
therapy
.
Initial
therapy
for
HL
patients
is
based
on
the
histology
of
the
disease
,
the
anatomical
stage
,
and
the
presence
of
poor
prognostic
features
.
Patients
with
early
stage
disease
are
treated
with
combined
modality
strategies
using
abbreviated
courses
of
combination
chemotherapy
followed
by
involved-field
radiation
therapy
,
while
those
with
advanced
stage
disease
receive
a
longer
course
of
chemotherapy
often
without
radiation
therapy
.
Management
of
relapsed
/
refractory
disease
:
High
-dose
chemotherapy
(
HDCT
)
followed
by
an
autologous
stem
cell
transplant
(
ASCT
)
is
the
standard
of
care
for
most
patients
who
relapse
following
initial
therapy
.
For
patients
who
fail
HDCT
with
ASCT
,
brentuximab
vedotin
,
palliative
chemotherapy
,
nonmyeloablative
allogeneic
transplant
,
or
participation
in
a
clinical
trial
should
be
considered
.
Diseases
Validation
Diseases presenting
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated