world cancer report - iarc

Fig. 5.106 Five-year relative survival rates after
diagnosis of Hodgkin disease.
Fig. 5.107 Five-year relative survival rates after
diagnosis of non-Hodgkin lymphoma.
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Hodgkin disease
In contrast to non-Hodgkin lymphomas,
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centres would use radiotherapy for early
stage (IA or IIA) disease, although there is
a trend towards considering limited
chemotherapy as an option. All other
stages should have chemotherapy, and
the traditional “gold standard” MOPP
(mustine, vincristine, procarbazine and
prednisone) therapy has been superseded
by ABVD (adriamycin [doxorubicin],
bleomycin, vinblastine and dacarbazine)
which appears to be as efficacious without
the adverse effects (particularly related
to fertility and the development of second
malignancies). The German Hodgkin
Disease Study Group has proposed a
prognostic model for advanced stage disease,
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which influence outcome. These are age,
sex, histology, B symptoms, number of
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involved sites, bulk of disease and erythrocyte
sedimentation rate. Using such
models it may be possible to identify poor
prognosis patients who will benefit from
more aggressive high-dose therapies,
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mustard, bleomycin, vincristine,
etoposide and prednisone) or BEACOPP
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Survival for both Hodgkin disease and
non-Hodgkin lymphomas has improved
markedly with time, in response to the
development of more effective
chemotherapy and bone marrow transplantation.
Five-year survival after diagnosis
of non-Hodgkin lymphoma patients in
most developed countries is more than
50%, but only 17-35% in developing countries
(Fig. 5.107). Currently, survival of
Hodgkin disease patients is related to
extent of disease at diagnosis; overall, at
five years it is between 70% and 90% in
North America and Europe, but only 30-
55% in developing countries (Fig. 5.106).
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management. Blood, 93: 761-779.
Lymphoma
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