Hematology/oncology clinics of North America
-
Hematol. Oncol. Clin. North Am. · Jun 1989
ReviewSecond neoplasms in Hodgkin's disease: current controversies.
Aggressive, multimodal treatment of Hodgkin's disease has led to dramatic increases in survival but not without significant early toxicity and late complications. The most serious late complication is the development of a secondary neoplasm. These secondary cancers include acute nonlymphocytic leukemia, non-Hodgkin's lymphoma, and various solid tumors.
-
Hematol. Oncol. Clin. North Am. · Jun 1989
ReviewNonmalignant complications of therapy for Hodgkin's disease.
Patients successfully treated for Hodgkin's disease provide the oncologist with an opportunity and a responsibility to evaluate long-term adverse effects of staging procedures and treatment regimens. This is necessary both to better understand the often unique clinical problems that develop long after completion of treatment for Hodgkin's disease and to more critically evaluate new treatment programs by comparison with existing effective but toxic regimens. Long-term survivors of Hodgkin's disease have various, often subclinical, cardiac abnormalities that result from both radiation and chemotherapy. ⋯ A variety of immunologic disturbances exists before and after treatment and predisposes to significant viral and bacterial infections. Finally, hypothyroidism and premature gonadal failure may follow therapy and require long-term hormone replacement. Further therapeutic advances for Hodgkin's disease will continue to alter this spectrum of complications, which, if unrecognized, may produce significant ongoing morbidity for long-term survivors.
-
This article discusses the presentation and evolution of therapy of pediatric Hodgkin's disease, contrasted with developments in adults. The issues of staging, treatment, and toxicity of radiotherapy, chemotherapy, and combined modality therapy are discussed. Recommendations for therapy are presented.