Hodgkin's lymphoma

Question 1

What are the subtypes of Hodgkins lymphoma?

Answer 1

• Classical

* nodular lymphocyte predominant (rare)

Question 2

Describe the pathology of classic Hodgkin lymphoma

Answer 2

• Binucleate neoplastic cell resembles atypical activated B cell as is seen in some in some viral infections (e.g. EBV) - very few malignant cells
• Characterised by strong expression of CD30 and loss of some B-cell antigens
• 40% associated with EBV infection

Question 3

What is the prevention of Hopkins lymphoma?

Answer 3

•Usually presents with painless, rubbery lymphadenopathy
- neck lump
- cough and shortness of breath (enlarged mediastinal nodes)
•May have B symptoms: night sweats, weight loss or unexplained fever
•Itch
•Alcohol related pain (rare)

Question 4

Blood tests for Hodgkins lymphoma

Answer 4

• FBC
• UEs
• LFTs
• ESR
• LDH

Question 5

What tests may be required pre treatment in those with Hodgkins lymphoma?

Answer 5

• Echocardiogram

* Pulmonary function tests

Question 6

What are the factors affecting the treatment decision for hodkins lymphoma?

Answer 6

• Stage
• Age
• Performance status
• Co-morbidities (and other background illnesses)

Question 7

What is the treatment of Hodgkins lymphoma?

Answer 7

• Early stage: Chemotherapy follows by radiotherapy

* Advanced stage: chemotherapy

Question 8

What is ABVD?

Answer 8

• A= adriamycin (doxorubicin)
• B= bleomycin
• V = vinblastine
• D = dacarbazine

Given on days 1 and 15 on the 28 say cycle

Question 9

What should you do if on cycle 3 of chemo for Hodgkins lymphoma there is a negative PET scan?

Answer 9

Remove bleomycin

Question 10

What are the late effects of Hodgkins lymphoma?

Answer 10

• Malignancy - lung cancer risk
• Cardiac - cardiomyopathy
• Pulmonary - pneumonitis
• Fertility - offer males sperm preservation
• Endocrine - hypothyroidism