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The cure of Hodgkin lymphoma in the 20th century is another one of cancer's biggest success stories. Breakthroughs in radiation therapy and chemotherapy paired with careful clinical research transformed an invariably fatal disorder into one that is routinely cured.
The impact of this success story was, however, much greater because it created optimism for the treatment of cancer in general, and demonstrated the potential for a multidisciplinary approach to diagnosis and management. In the vanguard, Hodgkin lymphoma investigators conducted rigorous, randomized controlled clinical trials as a means to advance therapy.
Another important lesson from the Hodgkin's experience was the price of cure. The recognition of late adverse effects from radiation therapy and chemotherapy in the form of second cancers, heart and blood vessel disease, and sterility shaped subsequent research efforts to maintain or improve cure rates with fewer complications, an important goal in a disease that primarily affects individuals in their 20s and 30s.
Today, as more than 80 percent of patients are cured after primary treatment, a major emphasis is now placed on survivorship. Sir Thomas Hodgkin is credited with the initial description of the clinical disorder that bears his name. In , he reported on a group of patients with enlargement of lymph nodes and spleen that differed from the major known maladies of the day.here
What’s New in Hodgkin Lymphoma Research?
Some 60 years later, pathologists in Germany and the U. At about the same time, two physicians applied X-rays, then newly discovered by William Roentgen, to enlarged lymph nodes in Hodgkin patients, reporting remarkable tumor reductions. These observations, together with increased understanding of the patterns of spread, led to advancements in the application of radiation therapy to larger fields in the s through the s. The introduction of the linear accelerator a radiation machine used to treat cancer in the treatment of Hodgkin lymphoma at Stanford University resulted in cures of early-stage lymphoma.
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Meanwhile, a team at the National Cancer Institute safely combined four chemotherapy drugs mustard, vincristine, procarbazine, and prednisone known as the "MOPP" regimen and reported the first cures of advanced Hodgkin lymphoma in Steadily improving techniques for defining the extent and location of disease staging has allowed appropriate modalities of treatment to be selected for individual patients. The late s and 80s presented new challenges in the recognition of adverse effects associated with MOPP and radiation therapy, some of which were not apparent for decades after treatment.
Hodgkin lymphoma: A review and update on recent progress
This time period also featured another major advance in an alternative four-drug chemotherapy regimen doxorubicin, bleomycin, vinblastine, and dacarbazine , known as "ABVD," that proved to be more effective than MOPP in treating advanced disease and had fewer side effects. The most recent advance in Hodgkin lymphoma management has come in the form of diagnostic imaging.
Application of FDG-PET in clinical studies allows physicians to limit more toxic treatments to the subset of patients who are likely to benefit while sparing the majority from adverse effects.