Stages of Hodgkin’s lymphoma | Hodgkin’s Lymphoma

Stages of Hodgkin’s lymphoma

The stages of Hodgkin lymphoma are classified according to Ann-Arbor, which is also used for non-Hodgkin lymphoma. The number and distribution of the affected lymph node stations in the body is decisive, with the diaphragm serving as an important and clinically relevant marker. There are 4 stages in total: I) Infection of one (1) lymph node region or one (1) extranodal focus II) Infection of 2 or more lymph node regions or extranodal focuses, whereby these are located exactly on one side of the diaphragm (above or below) III) Infection of 2 or more lymph node regions or IV) Disseminated, i.e. diffusely distributed, infestation of one or more extralymphatic organs, whereby the lymph node status is no longer important; extranodal foci are regions in which the cells and thus the tumor have left the lymph node and spread to other tissues.

Extralymphatic organs are all organs except the lymph nodes, spleen and thymus. Additional designations are also given, e.g. A or B for the presence (B) or absence (A) of B symptoms. Based on these stages, the prognosis and therapy options can be roughly derived.

Therapy of Hodgkin’s lymphoma

The therapy of Hodgkin’s lymphoma always aims at cure, regardless of the stages, but the way of treatment is determined by the stages. Basically, there are two pillars of therapy for Hodgkin’s lymphoma: intensive chemotherapy with the application of effective drugs with many side effects on the one hand and radiotherapy on the other hand. Both methods have the purpose of destroying the degenerated cells in order to cure the tumor and thus the disease.

In stages 1 and 2, due to the rather localized swelling of the lymph nodes, the therapy by means of radiation is the main therapy, which is accompanied by chemotherapy, whereas in stages 3 or 4, chemotherapy plays the main role. This is generally administered with the help of fixed treatment regimens. The ABVD regimen (with the substances adriamycin, bleomycin, vinblastine and dacarbazine) and the BEACOPP regimen (consisting of bleomycin, etoposide, adriamycin, cyclophosphamide, oncovin, procarbazine and prednisone) are widely used in Hodgkin’s lymphoma.

These substances are administered in several cycles over weeks at fixed doses and intervals depending on the stage and cause the tumor cells to die or be inhibited. However, this therapy is rich in side effects such as nausea, vomiting and hair loss. The radiation can be used in a more targeted manner and uses high-energy rays to destroy Hodgkin’s lymphoma without damaging much healthy tissue. However, the risk of second malignancies is always increased after the therapy.The exact therapy for Hodgkin’s lymphoma is complicated and always involves individual assessment, since other risk factors and circumstances that the patient brings with him/her are also taken into account in the decisions.