Hodgkin's lymphoma is a type of cancer that affects the lymphatic system. It is characterized by the presence of Reed-Sternberg cells on histology and spreads in an orderly fashion to contiguous lymph nodes. Risk factors include certain viruses, a weakened immune system, and age. Symptoms typically include enlarged, painless lymph nodes. It is diagnosed through an excisional lymph node biopsy and stages are determined by how many lymph nodes are affected and if it has spread. Treatment depends on the stage and includes chemotherapy, with regimens like ABVD being effective. Long term complications can include secondary cancers, short stature, and sterility.
Hodgkin’s disease was initially described as an inflammatory
disease (hence the term “disease”), but is clearly
recognized and treated as a malignant lymphoma (hence the
more accurate term Hodgkin’s lymphoma (HL) is used
synonymously with Hodgkin’s disease).
The management of Hodgkin’s lymphoma has evolved from
extended-field radiation alone as the main therapy to a
combined-modality approach with
chemotherapy and radiation, or chemotherapy alone.
Painles lymphadenopathy
Systemic symptoms- unexplained fevers, drenching night sweats, weight loss, generalize pruritus, fatigue, and alcohol-induced pain in tissues involved by HD
Mediastinal mass on a routine chest radiograph
90% of patients present with contiguous sites of involvement or Extension from adjacent lymph nodes
Hematogenous (liver or multiple bony sites) Involvement of the bones may cause blastic changes, especially in the vertebrae (creating the classic “ivory vertebra” on plain radiographs), pelvis, sternum, or ribs
Nearly all patients with hepatic or bone marrow involvement by Hodgkin lymphoma have extensive involvement of the spleen
Rare- Gut-associated lymphoid tissues such as Waldeyer ring and Peyer patches, Upper aerodigestive tract, Central nervous system, and Skin
oth Hodgkin's lymphoma and non-Hodgkin's lymphoma are lymphomas — a type of cancer that begins in a subset of white blood cells called lymphocytes. Lymphocytes are an integral part of your immune system, which protects you from germs.
This is a lecture on Lymphoma, exploring the different types and subtypes of Lymphomas. It also discusses the epidemiology, stages, clinical features, diagnosis, treatment and prognosis.
This was presented to undergraduate medical students at University Teaching Hospital (UTH), department of Cancer Disease Hospital by Nghitukuhamba Tangi Elikana Kalipi (6th year medical student) at Cavendish University Zambia, School of Medicine.
Background
Definition
Lymphoma is a malignant proliferation of mature lymphocytes that accumulate in lymph nodes ± other tissue, often as a solid tumour. Differs from leukaemia, which arises in the bone marrow and is present in the blood.
Hodgkin's lymphoma represents 20% of all lymphomas, and is characterised by the presence of 'mirror-image' binucleated Reed-Sternberg cells on light microscopy.
Hodgkin's lymphoma is a B-cell cancer.
Sub-types
Common: nodular sclerosis (70%), usually in young patients, and mixed cellularity (25%), usually in old patients. Both have a good prognosis.
Rare (5%): lymphocyte-rich (excellent prognosis) or lymphocyte-depleted (bad prognosis).
Epidemiology
Lifetime risk: 1/400.
Occurs any age but peaks at 15-30 and 75-80.
Commoner in men.
Hodgkin’s disease was initially described as an inflammatory
disease (hence the term “disease”), but is clearly
recognized and treated as a malignant lymphoma (hence the
more accurate term Hodgkin’s lymphoma (HL) is used
synonymously with Hodgkin’s disease).
The management of Hodgkin’s lymphoma has evolved from
extended-field radiation alone as the main therapy to a
combined-modality approach with
chemotherapy and radiation, or chemotherapy alone.
Painles lymphadenopathy
Systemic symptoms- unexplained fevers, drenching night sweats, weight loss, generalize pruritus, fatigue, and alcohol-induced pain in tissues involved by HD
Mediastinal mass on a routine chest radiograph
90% of patients present with contiguous sites of involvement or Extension from adjacent lymph nodes
Hematogenous (liver or multiple bony sites) Involvement of the bones may cause blastic changes, especially in the vertebrae (creating the classic “ivory vertebra” on plain radiographs), pelvis, sternum, or ribs
Nearly all patients with hepatic or bone marrow involvement by Hodgkin lymphoma have extensive involvement of the spleen
Rare- Gut-associated lymphoid tissues such as Waldeyer ring and Peyer patches, Upper aerodigestive tract, Central nervous system, and Skin
oth Hodgkin's lymphoma and non-Hodgkin's lymphoma are lymphomas — a type of cancer that begins in a subset of white blood cells called lymphocytes. Lymphocytes are an integral part of your immune system, which protects you from germs.
This is a lecture on Lymphoma, exploring the different types and subtypes of Lymphomas. It also discusses the epidemiology, stages, clinical features, diagnosis, treatment and prognosis.
This was presented to undergraduate medical students at University Teaching Hospital (UTH), department of Cancer Disease Hospital by Nghitukuhamba Tangi Elikana Kalipi (6th year medical student) at Cavendish University Zambia, School of Medicine.
Background
Definition
Lymphoma is a malignant proliferation of mature lymphocytes that accumulate in lymph nodes ± other tissue, often as a solid tumour. Differs from leukaemia, which arises in the bone marrow and is present in the blood.
Hodgkin's lymphoma represents 20% of all lymphomas, and is characterised by the presence of 'mirror-image' binucleated Reed-Sternberg cells on light microscopy.
Hodgkin's lymphoma is a B-cell cancer.
Sub-types
Common: nodular sclerosis (70%), usually in young patients, and mixed cellularity (25%), usually in old patients. Both have a good prognosis.
Rare (5%): lymphocyte-rich (excellent prognosis) or lymphocyte-depleted (bad prognosis).
Epidemiology
Lifetime risk: 1/400.
Occurs any age but peaks at 15-30 and 75-80.
Commoner in men.
Similar to Paithankar Adwait 7610 m2a Hodgkins Lymphoma hemat.pptx (20)
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
2. Hodgkin disease
Definition:
A neoplastic transformation of lymphocytes particularly in lymph nodes.
Characterized by:
1) the presence of Reed-Sternberg cells on histology
2) spreading in an orderly fashion to contagious lymph nodes
( Forexample, Hodgkin lymphoma that starts in thecervical lymph nodes
may spread first to the supraclavicular nodes then to the axillary nodes )
⚫ 6% of childhood cancer
⚫ 5% of cancer in < 14 yr
⚫ 15% in person 15-19 yr
⚫ Rare < 10 yr
3. Red-Sternberg cells
Largecells ( >45um in diameter) with classically binucleate or
bilobed central nucleus each with a large acidophilic central
nucleoli surrounded byaclear halo. “owl’seyeappearance”
4. Epidemiology of Hodgkin’s lymphoma
⚫ Hodgkin disease has bimodal agedistribution--onepeak in the 20s
and 60s.
⚫ Early peak middle to late 20s
⚫ Second peak after50 yr
⚫ Sex Male : Female
4: 1 for3-7 yr
3: 1 for7-9 yr
1-3: 1 for > 10 yr
⚫ 100 folds risk forunaffected monozygotictwin of affected twin
⚫ Associated with specific HLA antigen
⚫ Infectiousagents
Human herpesvirus 6
CMV
Epstein – Barrvirus
⚫ Immunodeficiency
5. Etiology/Risk Factors
Doctors seldom know why one person develops
Hodgkin lymphomaand anotherdoes not. But
research shows thatcertain risk factors increase the
chance thata person will develop thisdisease.
Having one or more risk factors does not mean that a
person will develop Hodgkin lymphoma. Most people
who have risk factors neverdevelopcancer.
6. Risk Factors
1) Certain viruses:
Epstein-Barr virus (EBV)
Human immunodeficiency virus (HIV)
2) Weakened immunesystem:
inherited condition
certaindrugs used afteran organ transplant
3) Age:
Hodgkin lymphoma is mostcommonamong teensand adults aged 15 to
35 years and adults aged 55 years and older.
4) Family history:
Family members, especially brothers and sisters, of a person with
Hodgkin lymphoma orother lymphomas may havean increased chance
of developing thisdisease.
7. Lymphocyte Predominant
10-15% of patients
More common in male
Younger patients
Localized disease
Has best prognosis
Mixed cellularity
30% of patients
< 10 yr of age
Advanced disease
Extranodal extension
Lymphocyte depletion
Rare in children
Common with HIV
Has worst prognosis
Nodular sclerosis
Most common
40% of younger patients
70% of adolescents
Classification
Rye Classification System
8. REAL Classification
( Revised European – American Classification of Lymphoid Neoplasms )
⚫Nodular lymphocyte predominance
⚫Classical Hodgkin lymphoma
⚫Lymphocyte rich
⚫Mix cellularity
⚫Nodularsclerosis
⚫Lymphocyte depletion
⚫ Anaplastic large cell lymphoma Hodgkin like
9. Enlarged, painless, rubbery, non- erythematous, nontender lymph nodes are
the hallmarkof thedisease.
May become painful afterdrinking alcohol
Hepatosplenomegaly
Cough, dyspnea, hypoxia
Pleural orpericardial effusion
Heptocellulardysfunction
B.M infiltration(Anemia, neutropenia, thrombocytopenia)
25% have ''B'' symptoms
Although pruritus is common in thedisease it is not one of the ‘’B’’ symptoms.
Cervical, supraclavicularand axillary lymphadenopathyare the most common
initial signsof thedisease.
Disease belowdiaphragm is rare (only3%)
Clinical presentation
10. Systemic Symptoms (B symptoms)
⚫Important in staging
⚫Unexplained fever > 390C
⚫ Weight loss > 10% in 3m
⚫ Drenching night sweats
Immune System abnormalities
⚫Anergy to delayed-hypersensitivity skin test
⚫Abnormal cellular immune response
⚫ Decreased CD4:CD8 ratio
⚫ Reduce natural killer cell cytotoxicity
11. Extralymphaticsites may be involved such as:
# Spleen
# Liver
# Bone marrow
# Lung
# CNS
Extralymphatic involvement is morecommon with
non-hodgkin lymphoma.
Emergencypresentation:
Infections
SVC obstruction ( facial edema, increased JVP
and Dyspnea)
12. Thedoctorconsiders the following todetermine the
stageof Hodgkin lymphoma:
The numberof lymph nodes affected.
Whether these lymph nodes areon one or both sides of
thediaphragm.
Whether thedisease has spread to the bone marrow,
spleen, liver, or lung.
Each stage is divided into A or B symptomsaccording to
the presence of systemic symptoms.
Staging of Hodgkin’s Lymphoma
13. Ann Arbor Staging Classification for Hodgkin
Disease
StageI
Involvementof a single lymph node (1)
orof a singleextra lymphatic siteororgan(1f)
StageII
Involvementof twoor more lymph node regionson the same side of
thediaphragm(II)
or localised involvementof an extra lymphaticsite
ororganand oneor more lymph node regionson the same side of the
diaphragm (IIf)
14. Stage III
Involvement of lymph node regions on both sides of the
diaphragm (III) which may be accompanied by the involvement of
spleen (IIIS) or by localized involvement of an extra lymphatic site or
organ ( IIIf) or both ( IIIsf)
Stage IV
Diffuse or disseminated involvement of one or more
extra lymphatic organs or tissues with or without associated lymph node
involvement.
The absence or presence of fever > 38C for three consecutive days ,
drenching night sweats , or unexplained loss of > 10% body weight in
the 6 months preceding admission are to be denoted in all cases by
the suffice letters A & B respectively.
15.
16. DIAGNOSIS
Anexcisional lymph node biopsy is theessential first step in diagnosis.
A biopsy is theonlysureway todiagnose Hodgkin lymphoma.
⚫ Excisional Biopsy
⚫ Light Microscopy
⚫ Immunocytochemistry
⚫ Molecular Studies
⚫ ChestX – Ray
⚫ Mediastinal Mass
⚫ CT Scan
⚫ Chest
⚫ Abdomen
⚫ Pelvis
⚫ Blood CP & ESR
⚫ LFT’s
⚫ BoneMarrow Aspiration
⚫ Serum Copper& Ferritin
⚫ Bone Scan
⚫ Gallium 67 Scan / FDG/PET
19. Therapy isentirely based on thestage.
Localized disease ( stage IA and IIA ) is managed predominantlywith
radiation.
All patientswithevidenceof ‘’B’’ symptomsaswell as stage III and IV
are managed withchemotherapy.
The most effective combination chemotherapeutic regimen for
Hodgkin lymphoma is ABVD ( adriamycin, bleomycin, vinblastinand
dacarbazine).
ABVD is superior to MOP (meclorethamine, vincristin(oncovin) ,
prednisoloneand procarbazine) becauseABVD has fewersideeffects
suchas:
1) Permanentsterility
2) Secondarycancerformation
3) Aplasticanemia
4) Peripheral neuropathy
TREATMENT
20. International Prognostic Index
The International Prognostic Index (IPI) was first developed to help
doctors determine the prognosis for people with fast-growing
lymphomas. The indexdepends on 5 factors:
1) The patient’sage
2) Thestageof the lymphoma
3) Whetheror not the lymphoma is in organsoutside the lymph system
4) Performance status (PS) – howwell a person can complete normal
dailyactivities
5) The blood (serum) level of (LDH)
21.
22. LONG TERM COMPLICATIONS
⚫Secondary malignancy
⚫ Acute Myelogenous Leukemia
⚫ Non Hodgkin lymphoma
⚫ Carcinomasof breast , lungs & thyroid
⚫Shortstature
⚫Hypothyroidism
⚫Sterility
⚫Dental caries
⚫Subclinical pulmonary dysfunction
⚫Ischemic heartdisease
