შეჯამება
განსაზღვრება
ანამნეზი და გასინჯვა
ძირითადი დიაგნოსტიკური ფაქტორები
- lymphadenopathy
სხვა დიაგნოსტიკური ფაქტორები
- unexplained fevers
- night sweats
- weight loss
- dyspnea
- cough
- chest pain
- superior vena cava syndrome (SVCS)
- abdominal pain
- pruritus
- alcohol-induced pain at involved sites
- hepatomegaly and/or splenomegaly
- tonsillar enlargement
რისკფაქტორები
- age 20-34 years and >55 years
- history of Epstein-Barr virus (EBV) infection
- family history of Hodgkin lymphoma
- young adults from higher socioeconomic class
- human leukocyte antigen (HLA) types
- Jewish ancestry
დიაგნოსტიკური კვლევები
1-ად შესაკვეთი გამოკვლევები
- CBC with differential
- comprehensive metabolic panel
- erythrocyte sedimentation rate (ESR)
- thyroid function tests
- screening for HIV, hepatitis B, hepatitis C
- CXR
- PET/CT scan
- gallium scan
- contrast-enhanced CT (neck, chest, abdomen, pelvis)
- excisional lymph node biopsy or core biopsy
- immunohistochemical studies
გასათვალისწინებელი კვლევები
- bone marrow biopsy
- echocardiogram or multigated acquisition (MUGA) scan
- pulmonary function tests
მკურნალობის ალგორითმი
early (stage I to II) classical HL: favorable disease and intended for combined-modality therapy
early (stage I to II) classical HL: favorable disease and intended for chemotherapy alone
early (stage I to II) classical HL: unfavorable disease (non-bulky or bulky) and intended for combined-modality therapy
early (stage I to II) classical HL: unfavorable disease (non-bulky) and intended for chemotherapy alone
early (stage I to II) classical HL: unfavorable disease (bulky) and intended for chemotherapy alone
advanced (stage III to IV) classical HL: intended for standard induction therapy (chemotherapy)
advanced (stage III to IV) classical HL: intended for standard induction therapy (chemoimmunotherapy)
advanced (stage III to IV) classical HL: intended for intensive induction chemotherapy
asymptomatic early (stage IA to IIA) NLPHL, non-bulky disease
asymptomatic early (stage IA to IIA) NLPHL, bulky disease; and symptomatic early (stage IB to IIB) NLPHL
advanced (stage III to IV) NLPHL
refractory or relapsed classical HL
refractory or relapsed NLPHL
კონტრიბუტორები
ავტორები
Alison Moskowitz, MD
Associate Attending
Lymphoma Service
Memorial Sloan-Kettering Cancer Center
New York City
NY
გაფრთხილება:
AM has received research support from ADC Therapeutics, Beigene, Miragen, Seattle Genetics, Merck, Bristol-Myers Squibb, Incyte, and SecuraBio. AM has received honoraria from Seagen, Affimed, Astra Zeneca, Bio Ascend, Imbrium Therapeutics L.P./Purdue, Janpix Ltd., Merck, Seattle Genetics, Pfizer, Tessa Therapeutics and Takeda.
მადლიერება
Dr Alison Moskowitz would like to gratefully acknowledge Dr Chris R. Kelsey, Dr Leonard R. Prosnitz, and Dr Timothy M. Zagar, the previous contributors to this topic.
გაფრთხილება:
CRK, LRP, and TMZ declare that they have no competing interests.
რეცენზენტები
Joachim Yahalom, MD
Radiation Oncologist
Director of Postgraduate Education
Department of Radiation Oncology
Memorial Sloan-Kettering Cancer Center
New York
NY
გაფრთხილება:
JY declares that he has no competing interests.
Rebecca Connor, MD
Chief Fellow
Section of Hematology and Oncology
Department of Internal Medicine
Wake Forest University Baptist Medical Center
Winston-Salem
NC
გაფრთხილება:
RC declares that she has no competing interests.
Kirit Ardeshna, MD, MA (Cantab), MB, BChir, FRCP, FRCPath
Consultant Haematologist
University College London Hospitals
London
UK
გაფრთხილება:
KA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
წყაროები
ძირითადი სტატიები
Eichenauer DA, Aleman BM, André M, et al. Hodgkin lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018 Oct 1;29(4 suppl):iv19-29.სრული ტექსტი აბსტრაქტი
National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Hodgkin lymphoma [internet publication].სრული ტექსტი
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014 Sep 20;32(27):3059-68.სრული ტექსტი აბსტრაქტი
გამოყენებული სტატიები
ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
დიფერენციული დიაგნოზები
- Non-Hodgkin lymphoma (NHL)
- Lymphadenopathy from other malignancies
- Infectious mononucleosis
მეტი დიფერენციული დიაგნოზებიგაიდლაინები
- NCCN clinical practice guidelines in oncology: pediatric Hodgkin lymphoma
- NCCN clinical practice guidelines in oncology: Hodgkin lymphoma
მეტი გაიდლაინები
შედით სისტემაში ან გამოიწერეთ BMJ Best Practice
ამ მასალის გამოყენება ექვემდებარება ჩვენს განცხადებას