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Overview of the approach to the adult survivor of classical Hodgkin lymphoma

Andrea K Ng, MD, MPH
Ann S LaCasce, MD
Section Editor
Larissa Nekhlyudov, MD, MPH
Deputy Editor
Alan G Rosmarin, MD


Hodgkin lymphoma (HL), formerly called Hodgkin's disease, accounts for approximately 10 percent of all lymphomas diagnosed in the developed world annually [1]. This amounts to approximately 8830 new cases of HL in the United States annually [2]. Over the past century, HL has been converted from a uniformly fatal disease to one that is curable in greater than 75 percent of patients worldwide. As a result, there are more than 30,000 long-term survivors of HL in the United States alone [3], and many more throughout the world, a substantial percentage of whom will have the majority of their care delivered by primary care providers. (See "Overview of the treatment of classical Hodgkin lymphoma in adults".)

HL is separated from the other lymphomas based on its unique clinical and pathologic features and can be divided into two major types:

Classical HL – Subtypes include nodular sclerosis HL, mixed cellularity HL, lymphocyte rich HL, and lymphocyte depleted HL. These constitute the vast majority of HL and will be discussed here.

Nodular lymphocyte-predominant HL – This is a less common and more indolent disease than classical HL and is therefore managed uniquely. (See "Clinical manifestations, pathologic features, and diagnosis of nodular lymphocyte-predominant Hodgkin lymphoma".)

HL survivors are at risk of developing therapy-related complications that may present years after treatment (eg, second malignancies, cardiac disease, radiation-induced hypothyroidism). These complications have surfaced as significant causes of increased mortality among HL survivors. Screening for some of these entities is advised in the hope that early detection may lead to better management.

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Literature review current through: Nov 2017. | This topic last updated: May 30, 2017.
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