Hodgkinïs
Lymphoma (HL) is a
disease typically affecting
children and
young adults, with more than 80% of
patients being cured. The other side of high
cure rate is that a fraction of
patients will receive excessive
antineoplastic radiochemotherapy resulting in the well-recognized late effects of HL
treatment. Current clinical and radiological characteristics used for
risk stratification in most
treatment centers
lead to mistaken stratification in almost one third of
patients.
Prognostic factors in HL are, mostly, crude direct
measures of
tumor burden and activity (stage, number of involved
lymph nodes, bulky
disease, B symptoms) or indirect surrogate
measures of
tumor burden and activity based on
laboratory parameters (
hemoglobin, s-
albumin levels). Clinical characteristics at presentation, as well as
protein immunoexpression and
Epstein-Barr virus (
EBV)
association, have also been identified as
prognostic factors in several studies. However, when sufficiently intensive
treatment for advanced stages is employed, adverse
prognostic factors tend to disappear. Thus, the identification of clinical and
biological factors that allow discrimination of
patients who may undergo a reduction in
treatment intensity is a current
goal to reduce late effects in HL(AU)