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Doctors Lounge - Oncology Answers
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| sallyboof
- Thu Feb 16, 2006 3:32 pm |
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Hi my husband has been diagnosed with hodgkin's lymphoma
that has spread to his lungs and liver we are still waitng on bone marrow results. he is 31 years old. and is starting chemo as soon as they find out the results for bone marrow and what sort of hodgkin's it is.
i would just like to know how affective is chemo.
and is there any other treatment to use if that fails
last year he only had swallen lymphnodes that done two biospys and revealed nothing so we went back for a repeat scan six months later to find lumps on lungs liver and down his spine.
i have read that hodgkins responds really well to treatment
they also found fluid on the heart could this be related
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| Dr. Tamer Fouad
- Fri Feb 17, 2006 3:21 am |
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 Chemotherapy has become curative for many patients with advanced stages of Hodgkin’s disease.
A doxorubicin-containing regimen, such as ABVD or ABVD alternating with MOPP, is the treatment of choice for patients presenting with stage III or IV disease, as demonstrated by a randomized phase III trial undertaken by the Cancer and Leukemia Group B (CALGB).
ABVD: doxorubicin + bleomycin + vinblastine + dacarbazine.
MOPP: mechlorethamine + vincristine + procarbazine + prednisone.
This trial showed higher complete response rates with ABVD and ABVD/MOPP (82% and 83%, respectively) than with MOPP alone (65%).
Up to one-third of patients with stage III or IV disease will relapse, usually within the first 3 years after therapy.
For patients who experience a relapse after initial combination chemotherapy, prognosis is determined more by the duration of the first remission than by the specific induction or salvage combination chemotherapy regimen.
Patients whose initial remission after chemotherapy was longer than 1 year (late relapse) have long-term survivals with salvage chemotherapy of 22% to 71%.
Patients whose initial remission after chemotherapy was shorter than 1 year (early relapse) do much worse and have long-term survivals of 11% to 46%.
In addition to duration after remission, resistant disease (see below), the presence B symptoms at relapse and extranodal disease are significant prognostic factors.
A variety of treatment regimens have been used for patients with relapsed Hodgkin’s disease. In addition to MOPP or ABVD in patients who received the opposite regimen initially, a number of other treatments have been used:
BEACOPP: bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine + prednisone.
COPP/ABVD: cyclophosphamide + vincristine + procarbazine + prednisone/doxorubicin + bleomycin + vinblastine + dacarbazine.
Stanford V: doxorubicin + vinblastine + mechlorethamine + etoposide + vincristine + bleomycin + prednisone.
MINE: mitoxantrone + ifosfamide + etoposide.
Best regards.
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