Hodgkin lymphoma is one of the best curable malignancies both in adult and pediatric oncology. Today, more than 80% of all patients can be cured with risk-adapted treatment including chemotherapy and radiotherapy. This progress is largely due to the development of multiagent chemotherapy more than 40 years ago and the improvements in radiotherapy. Since then, this fascinating disease has been in the focus of scientific and clinical research. Major more recent achievements were the definite proof that Hodgkin lymphoma is a true malignancy despite its peculiar histology with the Hodgkin and Reed-Sternberg cells derived from “crippled” B-lymphocytes.
Establishing immortal cell lines from patients with end-stage disease initiated a variety of different research activities into the pathophysiology, immunology, and treatment. The discovery of the Ki-1 antigen that was expressed in high density on H-RS cells substantially improved the prognostic precision since nearly all malignant cells in Hodgkin lymphoma tissue are strongly expressing this antigen, which was later designated to the CD30 cluster. Monoclonal antibodies against this antigen were not only being successfully used for immunophenotyping but also exploited therapeutically. After a number of nonsuccessful clinical trials with antibody constructs or fully human monoclonal antibodies targeting CD30, this story now seems to come full circle with the advent of an anti-CD30 antibody-drug conjugate that has given remarkable responses in end-stage Hodgkin lymphoma patients.
Due to the substantially improved prognosis and the generally young age of patients affected, Hodgkin lymphoma has also become a model to study long-term effects of successful radiotherapy and chemotherapy. Today, more patients die from treatment-related long-term toxicity than from uncontrolled Hodgkin lymphoma. We must thus very carefully balance our attempts to further improve disease control with the need to keep the risk of long-term consequences as low as possible. In addition, there are also a number of relevant physical and psychosocial issues that need to be further exploited including the risk of infertility, and fatigue. Fortunately, after more than 20 years of standstill, we now experience the development of new-targeted treatment also for patients with Hodgkin lymphoma. This hopefully might result in more individualized and less toxic treatments for our patients.
This book should give you an overview on past and current achievements in the area of Hodgkin lymphoma with a special emphasis on late effects and new treatment options.
Contents
Part I From Hodgkin’s Disease to Hodgkin Lymphoma
1 Epidemiology
2 The Role of Viruses in the Genesis of Hodgkin Lymphoma
3 Pathology and Molecular Pathology of Hodgkin Lymphoma
4 Microenvironment, Cross-Talk, and Immune Escape Mechanisms
Part II Diagnosis and Treatment
5 Clinical Evaluation
6 Functional Imaging
7 Prognostic Factors
8 Principles of Radiation Techniques in Hodgkin Lymphoma
9 Principles of Chemotherapy in Hodgkin Lymphoma
10 Treatment of Early Favorable Hodgkin Lymphoma
11 Treatment of Early Unfavorable HL
12 Treatment of Advanced Stage Hodgkin Lymphoma
13 Relapsed and Refractory Hodgkin Lymphoma
14 Pediatric Hodgkin Lymphoma
Part III Special Clinical Situations
15 Lymphocyte-Predominant Hodgkin Lymphoma
16 The Management of Hodgkin Lymphoma During Pregnancy
17 The Management of HIV-Hodgkin Lymphoma
18 The Management of Elderly Patients with Hodgkin Lymphoma
19 Allogeneic Transplantation for Relapsed Hodgkin Lymphoma
20 New Agents for Patients with Hodgkin Lymphoma
Part IV Survivorship
21 Quality of Life in Hodgkin Lymphoma
22 Second Malignancy Risk After Treatment of Hodgkin Lymphoma
23 Cardiovascular and Pulmonary Late Effects
24 Gonadal Dysfunction and Fertility Preservation in Hodgkin Lymphoma Patients
Part V Future Prospects
25 What Will We Learn from Genomics and Proteomics in Hodgkin Lymphoma?
26 Personalized Medicine in Hodgkin Lymphoma?
Index
Establishing immortal cell lines from patients with end-stage disease initiated a variety of different research activities into the pathophysiology, immunology, and treatment. The discovery of the Ki-1 antigen that was expressed in high density on H-RS cells substantially improved the prognostic precision since nearly all malignant cells in Hodgkin lymphoma tissue are strongly expressing this antigen, which was later designated to the CD30 cluster. Monoclonal antibodies against this antigen were not only being successfully used for immunophenotyping but also exploited therapeutically. After a number of nonsuccessful clinical trials with antibody constructs or fully human monoclonal antibodies targeting CD30, this story now seems to come full circle with the advent of an anti-CD30 antibody-drug conjugate that has given remarkable responses in end-stage Hodgkin lymphoma patients.
Due to the substantially improved prognosis and the generally young age of patients affected, Hodgkin lymphoma has also become a model to study long-term effects of successful radiotherapy and chemotherapy. Today, more patients die from treatment-related long-term toxicity than from uncontrolled Hodgkin lymphoma. We must thus very carefully balance our attempts to further improve disease control with the need to keep the risk of long-term consequences as low as possible. In addition, there are also a number of relevant physical and psychosocial issues that need to be further exploited including the risk of infertility, and fatigue. Fortunately, after more than 20 years of standstill, we now experience the development of new-targeted treatment also for patients with Hodgkin lymphoma. This hopefully might result in more individualized and less toxic treatments for our patients.
This book should give you an overview on past and current achievements in the area of Hodgkin lymphoma with a special emphasis on late effects and new treatment options.
Contents
Part I From Hodgkin’s Disease to Hodgkin Lymphoma
1 Epidemiology
2 The Role of Viruses in the Genesis of Hodgkin Lymphoma
3 Pathology and Molecular Pathology of Hodgkin Lymphoma
4 Microenvironment, Cross-Talk, and Immune Escape Mechanisms
Part II Diagnosis and Treatment
5 Clinical Evaluation
6 Functional Imaging
7 Prognostic Factors
8 Principles of Radiation Techniques in Hodgkin Lymphoma
9 Principles of Chemotherapy in Hodgkin Lymphoma
10 Treatment of Early Favorable Hodgkin Lymphoma
11 Treatment of Early Unfavorable HL
12 Treatment of Advanced Stage Hodgkin Lymphoma
13 Relapsed and Refractory Hodgkin Lymphoma
14 Pediatric Hodgkin Lymphoma
Part III Special Clinical Situations
15 Lymphocyte-Predominant Hodgkin Lymphoma
16 The Management of Hodgkin Lymphoma During Pregnancy
17 The Management of HIV-Hodgkin Lymphoma
18 The Management of Elderly Patients with Hodgkin Lymphoma
19 Allogeneic Transplantation for Relapsed Hodgkin Lymphoma
20 New Agents for Patients with Hodgkin Lymphoma
Part IV Survivorship
21 Quality of Life in Hodgkin Lymphoma
22 Second Malignancy Risk After Treatment of Hodgkin Lymphoma
23 Cardiovascular and Pulmonary Late Effects
24 Gonadal Dysfunction and Fertility Preservation in Hodgkin Lymphoma Patients
Part V Future Prospects
25 What Will We Learn from Genomics and Proteomics in Hodgkin Lymphoma?
26 Personalized Medicine in Hodgkin Lymphoma?
Index