clinical pathway of hodgkin lymphoma cancer

The clinical pathway for Hodgkin lymphoma (HL) emphasizes a systematic approach to diagnosis, treatment, and follow-up care, with the goal of enhancing patient outcomes. Classical Hodgkin lymphoma (cHL) is recognized as one of the most treatable cancers, boasting cure rates exceeding ۸۰% through modern combined therapies, which include chemotherapy and radiation therapy. Hodgkin lymphoma is categorized into two primary types: classical Hodgkin lymphoma and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). cHL, which constitutes approximately ۹۵% of cases, is marked by the presence of Reed-Sternberg cells and is further divided into four subtypes: nodular sclerosis, mixed cellularity, lymphocyte-rich, and lymphocyte-depleted. In contrast, NLPHL accounts for about ۵% of cases and typically exhibits slower growth, often diagnosed at an earlier stage. While the exact causes of Hodgkin lymphoma remain unclear, several risk factors have been identified, including viral infections, genetic predispositions, age, a weakened immune system, and environmental exposures. Diagnosis generally begins with a comprehensive medical history and physical examination, focusing on symptoms such as swollen lymph nodes, fever, night sweats, and unexplained weight loss. A definitive diagnosis is achieved through lymph node biopsy, supplemented by blood tests, imaging studies, and bone marrow biopsies to evaluate disease extent and exclude other conditions. Treatment strategies for Hodgkin lymphoma are customized based on disease stage, patient age, and overall health. The primary treatment modalities include chemotherapy, often the first line for advanced stages, with regimens like ABVD demonstrating high efficacy. Radiation therapy may accompany chemotherapy, particularly in early-stage cases, while stem cell transplants are considered for relapses. Immunotherapy options, such as brentuximab vedotin and checkpoint inhibitors, have also emerged for patients with relapsed or refractory disease. For early-stage favorable Hodgkin lymphoma, the recommended first-line treatment combines chemotherapy and radiation therapy , typically involving ABVD(Adriamycin, Bleomycin, Vinblastine, and Dacarbazine) followed by involved-field radiation. In cases of early-stage unfavorable disease, more intensive regimens like BEACOPP may be employed, potentially followed by consolidation radiation therapy based on treatment response. For advanced-stage Hodgkin lymphoma, ABVD remains the standard treatment, with escalated BEACOPP considered for high-risk patients. The guidelines also address the role of stem cell transplantation for those who do not achieve a complete response or experience relapse. Overall, early diagnosis significantly enhances the likelihood of successful treatment outcomes, underscoring the importance of awareness regarding symptoms and risk factors. Post-treatment follow-up is essential to monitor for recurrence and manage any long-term side effects of treatment. This typically includes regular physical examinations, imaging studies, and laboratory tests. The follow-up schedule may vary based on the initial stage of the disease and the treatment received.

کلیدواژه ها:

classical hodgkin lyphoma ، clinical pathway ، chemotherapy ، hodgkin lyphoma ، lymphocyte