Hodgkin’s Disease
Kathryn Janel Vasquez
Coastal Bend College - Nursing
HODGKIN’S DISEASE
Hodgkin’s lymphoma, formerly known as Hodgkin's disease, is a cancer of the lymphatic system, which is part of the immune system and is quite rare. In Hodgkin's lymphoma, cells in the lymphatic system grow abnormally and may spread beyond the lymphatic system. As Hodgkin's lymphoma progresses, it compromises your body's ability to fight infection. It affects areas such as the neck, axillary and groin areas of the body. (Hodgkin's Disease, n.d.)
Although anyone of age is susceptible to the disease, it’s more likely to affect people between ages of 20 to 34, than those people aged between 70 and older. The condition is more likely to happen in men
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Types of Hodgkin’s Disease
Hodgkin’s disease is divided into four main types, depending on the histological features identified during microscopy and these are described below.
• Lymphocyte predominant type – The lymphocyte is the main cell present. This type of Hodgkin’s lymphoma is uncommon, but is associated with the most optimal prognostic outlook.
• Nodular sclerosing type – Microscopic examination reveals well-defined nodules distinguished by their fibrous strands. This common form of Hodgkin’s disease accounts for around 70% of cases and is often associated with a positive prognostic outlook.
• Mixed cellularity type – This type is more common across populations from Asia and the Middle East and accounts for only 20% of cases in the UK, for example. This form of Hodgkin’s disease is associated with a less positive prognosis and requires an aggressive treatment approach.
• Lymphocyte depleted type – This form is associated with the worst prognosis. Reed Sternberg cells predominate, the lymphocytes are severely depleted and the reactive background is reduced. This aggressive form of Hodgkin’s disease accounts for only 5% of cases
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Surgery may be used in rare cases that occur in areas such as the stomach or thyroid, making sure that the disease has not spread outside of these areas. For treating the disease, radiation therapy is the preferred method over surgery.
The management for HD has dramatically changed over the past quarter century and primarily due to advances in radiation and chemotherapy. Because of this, the patients who have been diagnosed with the disease will survive, which is a remarkable achievement, given their fatal outcome. It is evident that patients with Hodgkin’s disease are at an increased risk for secondary cancers such as leukemia, and that may be associated with exposure to chemotherapy, radiation, or a combination of the two therapies.
These medical chemotherapy regimens that are given as an initial treatment for HD include MOPP, which are mechlorethamine, vincristine, procarbazine, and prednisone. ADVB, which is Adriamycin, bleomycin, and vinblastine and dacarbazine are also medications for treatment of the disease. Stanford V includes doxorubicin, vinblastine, mustard, bleomycin, vincristine, etoposide, and prednisone. BEACOPP include bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone. These sources of treatment are all given intravenously except prednisone and