Long-term complications of treatment for Hodgkin lymphoma

Haema 2012; 3(3): 285-297

by Paraskevi Roussou1, Stamatis Karakatsanis2

1Associate Professor of Internal Medicine-Hematology, Hematology Unit, 3rd University Department of Internal Medicine, General Hospital of Chest Diseases “Sotiria”,
2Hematology resident, Hematology and Lymphomas’ Clinic and Bone Marrow Transplantation Unit, General Hospital of Athens “Evaggelismos”

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Hodgkin lymphoma is a relatively rare malignancy in the general population but shows an increased incidence in young people. Although combination therapy has evolved, leading to extremely high cure rates and allowing reduced doses of both chemotherapy and radiotherapy, minimizing late effects of treatment has traditionally been a challenge. These include cardiovascular, respiratory, endocrine, developmental and psychological complications and the occurrence of secondary malignancies. These complications are important causes of increased mortality among survivors of Hodgkin lymphoma. Periodic monitoring for some of those complications is recommended in the hope that early diagnosis can lead to better treatment. Therefore, patients with Hodgkin lymphoma in complete remission should be periodically evaluated and monitored not only for recurrent disease but for possible long-term complications as well. It is worth noting that the combination therapies administered today are designed to be less toxic than the original ones, in an effort to reduce the incidence of complications. However long- term monitoring is still needed to fully assess their own complications, while it seems that interim PET/ CT in combination with more accurate prognostic markers and more effective drugs will be exploited in pursuit of the optimal therapy in Hodgkin’s lymphoma.