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Hodgkins lymphoma - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Excellent Posted in: Cancer
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1721 Questions
User :   my son aged 24 yrs was detected hodgkins lymphoma in 2008. after 8 cycles of ABVD chemo, it relapsed within 2 months. he was given 2 cycles GDP chemo as salvage, followed by autologous stem cell transplant in APr 2009. now, after a year, his disease has relapsed and he has been recommended 3 cycles of ICE chemo as salvage to be followed with allogenic stem cell transplant. Is a second stem cell transplant necessarily required in a relapsed case of hodgkins lymphoma? what other options do we have?
Doctor :   Hi
Doctor :   Iam
Doctor :   Let me read your query
Doctor :   Did your doctor recommend that?
User :   he said its the brightest option available, and he recommends this course of action more than any other
Doctor :   ok
Doctor :   People who have had Hodgkin's disease should have regular followup examinations after their treatment is over and for the rest of their lives.

User :   what do i do now? i am really worried.
User :   he had been under regular followups. it was on one of these follow ups the disease showed up.
Doctor :   the cycle of chemo
Doctor :   should be repeated at intervals
Doctor :   and the response to it differs
User :   he just had one cycle of ICE chemo last week. next is due on 16th of this month. he is doing well now., with his platelets counts improving steadily.
Doctor :   ok thats is a good sign
User :   thanks doc. just a wee bit of brightness. pls. advise what should be the furhter action after the 3 recommended cycles of chemo.
Doctor :   it depends on his response to the chemo
User :   as of?
Doctor :   how his counts are doing
Doctor :   like platelets and his general body health
Doctor :   and again all depends on the experience and expertise of the treating oncologist
Doctor :   WWW.WWWW.WW
Doctor :   WHere are you from?
User :   from delhi.
Doctor :   ok
Doctor :   were are you taking the treatment now?
User :   he is under care of dr Ashok Vaid from Medicity Hospital, gurgaon.
Doctor :   ok

Doctor :   So the treatment plan cannot be predicted now
Doctor :   it depends on the response
Doctor :   i cannot say what they might plan next
Doctor :   it varies
Doctor :   there are different varieties of hodgkins disease
Doctor :   some easy to cure some not
User :   sorry, doc. I am not too clear on this. Varies like? He has nodular schlerosis type.
Doctor :   and comes the staging of the disease etc

Doctor :   ok
Doctor :   Nodular sclerosis Is the most common subtype and is composed of large tumor nodules

Doctor :   There are no guidelines for preventing Hodgkin's lymphoma because the cause is unknown or multifactorial
User :   he had a bone marrow biopsy, which showed no evidence of disease in the marrow.
Doctor :   Risk factors include:
Sex: male
Ages: 15â??40 and over 55
Family history
History of infectious mononucleosis or infection with Epstein-Barr virus etc
Doctor :   ok
User :   ???
Doctor :   that might show different stage
Doctor :   stage 1 is limited to one lymp node
Doctor :   where as in stage 4 it spreads to all organs
User :   he is now in Stage IIIA/
Doctor :   ok
Doctor :   other than ABVD there is stanford v and BEACOPP treatment

Doctor :   The newer Stanford V regimen is typically only half as long as the ABVD but involves a more intensive chemotherapy schedule and incorporates radiation therapy.

Doctor :   BEACOPP is a form of treatment for stages > II mainly used in Europe.
User :   you mean, God forbid he has a relapse even after the present chemo, we still have viable optiions for treatment?
Doctor :   yes
Doctor :   the cure rate is high
Doctor :   Treatment of Hodgkin's disease has been improving over the past few decades
Doctor :   In one recent European trial, the 5-year survival rate for those patients with a favorable prognosis was 98%, while that for patients with worse outlooks was at least 85%.

User :   thats a relief, doc. you sure wiped a few creases off my brow.
Doctor :   so you have a lot of hope
Doctor :   yes but you should get expert opinions too
Doctor :   as this is a field where research is still going on
Doctor :   WWW.WWWW.WW Doctor :   You can get expert opinions through our website either by phone or by email if you wish so
User :   yes, this effort is towards the goal of getting expert opinion.
Doctor :   Hodgkinâ??s disease is considered one of the most curable forms of cancer, especially if it is diagnosed and treated early. Unlike other cancers, Hodgkin's disease is often very curable even in late stages.
Doctor :   With the right treatment, more than 90% of people with stage I or II Hodgkin's lymphoma survive for at least 10 years. If the disease has spread, the treatment is more intense but the percentage of people who survive 5 years is about 90%.
Doctor :   So dont worry
Doctor :   Pray and go ahead with the treatment
Doctor :   surely you he has a high chance of recovery
Doctor :   And the relapse rate is very important for the prognosis
Doctor :   for early relapses the prognosis is slightly less

Doctor :   but active treatment can help
Doctor :   It is important for patients to receive periodic examinations and imaging tests for years after treatment to check for signs of relapse and to check for the long-term effects of treatments.

Doctor :   There can be some adverse effects of the chemo later
Doctor :   like bleeding anemia heart disease lung disease thyroid disease etc
Doctor :   Did you understood what i said?

Doctor :   so relapse rate too have an impact on outcome of treatment
Doctor :   since his age is less he has better chance
User :   thats great. doc. thanks again. I perfectly understood you.
Doctor :   Ok
Doctor :   Is there anything else i can help you with?
User :   yes. i will keep updating his progress through his treatment. pls do keep giving me your opinion. thanks again.
Doctor :   Thanks for consulting ..Bye for now...
User :   bye, doc.
Doctor :   Bye..
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