INCTR: Newsletter -
[Cached Version]
Published on: 1/1/2004
Last Visited: 10/17/2008
Moderators: Dr. Corina Gonzalez, Pediatric Oncologist, Lombardi CancerCenter, Washington DC, USA, and Dr. Henning Bredenfeld, Medical Oncologist, University of Cologne, Germany.
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Dr. GONZALEZ: An 11-year-old Caucasian female living in the USA was admitted to the hospital because of progressive cervical lymphadenopathy, mediastinal mass and constitutional symptoms.Eight weeks earlier, the patient had noticed several tender swellings on the left side of her neck, which enlarged over time.A month prior to admission, intermittent fevers up to 38.5° C, non-productive cough and bilateral knee pain developed.
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Dr. GONZALEZ: What problems may be encountered in making a diagnosis of Hodgkin lymphoma?
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Dr. GONZALEZ: Do the different histological subtypes of Hodgkin lymphoma carry any prognostic value?
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Dr. GONZALEZ: Dr. Khan, do we absolutely need CT scans for the radiographic staging of Hodgkin lymphoma?
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Dr. GONZALEZ: Based on the history and investigations detailed by Dr. Khan and Professor Mokhtar, this patient has nodular sclerosis Hodgkin lymphoma involving more than two node regions on one side of the diaphragm, bulky mediastinal disease, and B symptoms.
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Dr. GONZALEZ: The treatment of childhood Hodgkin lymphoma consists of a combined modality approach, using chemotherapy plus or minus radiotherapy.
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Dr. GONZALEZ: Is there any role for radiotherapy upfront in cases of large mediastinal mass with secondary upper airway compression and respiratory distress?
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Dr. GONZALEZ: The classic chemotherapy regimens combine usually four non-cross resistant agents (MOPP or ABVD) and are outpatient regimens with easily manageable acute toxicities but potentially significant long-term toxicities (Table 2).