Treatment
As mentioned above, tailoring therapy for Hodgkin’s lymphoma is no easy task and several factors play a role in determining the best line of therapy for a particular patient. Some of those factors include:
- Histological type
- Stage and extent of the disease especially involvement of the spleen and liver
- Age of the patient
- Affection of the central nervous system
- Some lab markers like severe anemia and elevated ESR
- The presence or absence of B symptoms of lymphoma
Several scoring systems are present for assessing the patient based on these criteria to offer the best care and avoid side effects as much as possible.
Most cancer therapies aim towards what we call a complete remission, which is the complete disappearance of all signs of cancer including signs and symptoms, any radiological evidence or lab markers. In Hodgkin’s lymphoma, it can be achieved in about three fourths of all patients, but the ratio varies according to the criteria mentioned above.
If complete remission can’t be achieved, therapy aims towards achieving partial remission or at least preventing the disease from involving the bone marrow which has a detrimental effect on survival. To achieve these goals, several therapies are available including:
1) Chemotherapy
Chemotherapy is largely considered the standard of care for induction of complete remission, many combinations of chemotherapeutic agents exist and they can differ between countries and cancer centres, but the most commonly used is a combination between Adriamycin, Bleomycin, Vinblastine and These drugs affect cell division of cancer cells by targeting their DNA or their apparatus responsible for cell division. They are given for at least 6 months in the form of cycles, a cycle every 4 weeks.
After the 6 months pass and even before, some investigations are carried out to assess the response to therapy including CT scanning and PET scan, if response to primary therapy fails, then another method of chemotherapy is done called salvage chemotherapy. Salvage therapy can include single drugs or combinations.