Hodgkin's lymphoma is a malignancy that arises from germinal center B cell.

Histologically, there is a presence of multinucleated giant cells in a mixed inflammatory background.

It is also known as Hodgkin's disease, Hodgkin lymphoma or Hodgkin disease.

It commonly affects individuals ages 15-30 years old and those 55 years old and above.

The key morphologic characteristics include presence of Reed-Sternberg cells and lymphocyte-predominant cells.

Follow Up

Tests After Completion of Initial Therapy

  • Restaging via positron emission tomography-computed tomography (PET-CT) scan should be done after completion of chemotherapy, based on the Deauville criteria
    • Favorable, unfavorable, and aggressive classic Hodgkin's lymphoma (CHL) restaging should be based on the Deauville criteria
    • Restaging of nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) patients is recommended after completion of initial therapy
  • PET 5-Point Scale (Deauville Criteria)

  • Score PET-CT scan result
    1 No uptake
    2 Uptake ≤ mediastinum
    3 Uptake > mediastinum but ≤ liver
    4 Uptake moderately higher than the liver
    5 Uptake markedly higher than the liver &/or new lesions
    X New areas of uptake unlikely to be related to lymphoma
  • Biopsy & positron emission tomography-computed tomography (PET-CT) scan may be requested for patients with Deauville 4-5 score after completion of therapy
  • Computed tomography (CT) scan may be requested once during the 1st 12 months after completion of therapy, then as clinically indicated
  • Other imaging studies of initially involved sites (eg ultrasonography, chest radiography) may be repeated
  • The following should be tested annually 5 years after therapy completion:
    • Blood pressure
    • Complete blood count (CBC), platelets, chemistry profile
    • Thyroid Stimulating hormone (TSH) (for patients with radiotherapy to the neck)
    • Lipid profile (2x/year)
    • Annual breast examination with mammography & magnetic resonance imaging (MRI) is advised for women previously irradiated at the chest or axillary area
    • Colonoscopy every 10 yr for patients >50 years old

Timing of Follow-up

  • Yearly follow-up should be advised for the first 5 years after treatment
  • Patients should undergo complete physical examination & history taking every 2-4 months for 1-2 years, then every 3-6 months for the next 3-5 years
  • Complete blood count (CBC), platelet count, erythrocyte sedimentation rate (ESR), & chemistry profile should be obtained as clinically indicated
  • A low-dose computed tomography (CT) scan of chest may be requested after 5 years for patients at increased risk for lung cancer & have undergone treatment with non-alkylating chemotherapeutic agents, no previous radiation therapy, & no other risk factors
  • Thorough physical examination & psychologic evaluation is recommended every 4-6 month for the first 5 years
  • Physical exams & blood tests [complete blood count (CBC), erythrocyte sedimentation rate (ESR), blood chemistry] should be done for nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL) patients every 3-6 months for 1-2 years, then every 6-12 months for the next 3 years, then annually
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Oncology - Malaysia digital copy today!
Editor's Recommendations
Most Read Articles
29 Nov 2017
Rapid onset opioids may allow for more effective treatment of breakthrough cancer pain as their pharmacokinetic profile closely mimics the pain’s time course
Christina Lau, 22 Oct 2015
A 21-gene expression assay can identify patients with early-stage breast cancer who can skip adjuvant chemotherapy without facing an increased risk of recurrence at 5 years.
Elvira Manzano, 13 Sep 2017
Tisagenlecleucel, now US FDA approved, has made history as the first ever chimeric antigen receptor (CAR) T-cell therapy for B-cell precursor acute lymphoblastic leukaemia (ALL) – a breakthrough that has the potential to transform treatment for blood cancers that have not responded to standard therapies.
Naomi Adam, 01 Apr 2014

Colorectal cancer (CRC) is one of the most common cancers worldwide and its incidence is rising among Asians. Long-term survival outcomes are poor for CRC because patients often remain undiagnosed until the disease has reached an advanced stage. Panitumumab, a human IgG2 monoclonal antibody with high binding affinity for epidermal growth factor receptors, has shown encouraging results in the treatment of metastatic CRC (mCRC).