Physician, Kimmel Cancer Center, Department of Medical Oncology, Thomas Jefferson University, PA, USA
Received date: March 28, 2015; Accepted date: March 30, 2015; Published date: April 10, 2015
Citation: Pathak P (2015) Hodgkin’s Disease: Past to Present. J Blood Lymph 5:e118. doi: 10.4172/2165-7831.1000e118
Copyright: © 2015 Pathak P, This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Hodgkin’s disease (HD) is an uncommon malignancy accountingfor an incidence of 0.6% of all cancers. In 2015, an estimated 9,050people will be diagnosed with HD in the United States and 1,150people will die from the disease . From 2007 to 2011, the incidencerates for HD have been stable but death rates have been steadilydecreasing by 2.2% per year for men and 2.7% for women per year forwomen. The latter have been attributed to better therapeutic interventions.
Once considered, the “inexorably fatal condition”, HD had long beena subject of controversy with respect to its nature, etiology and therapy.Initially thought to be an infectious disease due to its association withtuberculosis, definitive evidence of its neoplastic nature came in the1960’s when cytogenetic studies confirmed its clonal derivation and aneuploidy.
The contiguous nature of its spread via lymphatic channels whichwas demonstrated when laparotomy was used as a staging tool at theStanford University Medical Center for the first time in 1969, changedprevailing ideas of its treatment from essentially symptomatic tocurative . Treatment of HD has been fraught with controversy,ranging from surgical approaches which are no longer used,radiotherapy (extended field radiation versus involved field radiation) and chemotherapy (single versus multidrug regimens).
This disease has served as a model for the development of combinedmodality therapy with a multidisciplinary approach involvingradiation oncologists, medical oncologists and radiologists. It has alsoserved as the basis for interim PET/CT scans in the prognostication ofother lymphomas and its treatment started the era of multi-agent chemotherapy for other hematologic malignancies.
HD has also been instrumental in the designing of long term studieswhich enables the assessment of the long-term effects of a treatmentand helps us seek a balance between treatment effectiveness and theavoidance of long term gonadal, cardiac and secondary neoplastic complications.
Currently, the standard of care for previously untreated HD in theUnited States is combined modality therapy for Stage I and Stage IIdisease and combination chemotherapy (ABVD, Stanford V andBEACOPP) for advanced stages . The 5 year survival rates for HDrange from 90.8% for localized disease to 76.2% for distant disease .Thus, we have come a long way from a potentially fatal disease to an imminently curable one.
In this issue, Salvatore et al. present a case of a 44 year old womanwho presented with a bulky Stage II Hodgkin’s lymphoma withmediastinal syndrome. The patient had been aware of the tumor forabout three years prior to her admission. This case report showcases afew important details- namely the natural history of Hodgkin’s diseasewhich is rare with current medical advances, the effectiveness ofcurrent treatments and the social stigma of cancer which prevented her from seeking medical treatment leading to the fatal outcome.