world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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Fig. 5.106 Five-year relative survival rates after<br />
diagnosis of Hodgkin disease.<br />
Fig. 5.107 Five-year relative survival rates after<br />
diagnosis of non-Hodgkin lymphoma.<br />
REFERENCES<br />
1. Cartwright RA, Gilman EA, Gurney KA (1999) Time<br />
trends in incidence of haematological malignancies and<br />
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Curr Opin Oncol, 12: 383-394.<br />
3. Jaffe ES, Lee Harris N, Stein H, Vardiman JW, eds<br />
(2001) World Health Organization Classification of<br />
Tumours. Pathology and Genetics of Tumours of<br />
Haematopoietic and Lymphoid Tissues, Lyon, IARCPress.<br />
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ML, Delsol G, Wolf-Peeters C, Falini B, Gatter KC (1994) A<br />
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therapy protocols, so-called “second and<br />
third generation regimens”, have met with<br />
little success. However, the introduction<br />
of the International Prognostic Index may<br />
help to identify patients who will benefit<br />
from more aggressive strategies [9]. In<br />
patients who relapse after conventional<br />
therapy, and who still have “sensitive disease”,<br />
high-dose chemotherapy with stem<br />
cell rescue appears to offer a reasonable<br />
salvage option.<br />
Hodgkin disease<br />
In contrast to non-Hodgkin lymphomas,<br />
the management of Hodgkin disease is<br />
usually dictated by the stage of disease<br />
rather than the histology [10,11]. Most<br />
centres would use radiotherapy for early<br />
stage (IA or IIA) disease, although there is<br />
a trend towards considering limited<br />
chemotherapy as an option. All other<br />
stages should have chemotherapy, and<br />
the traditional “gold standard” MOPP<br />
(mustine, vincristine, procarbazine and<br />
prednisone) therapy has been superseded<br />
by ABVD (adriamycin [doxorubicin],<br />
bleomycin, vinblastine and dacarbazine)<br />
which appears to be as efficacious without<br />
the adverse effects (particularly related<br />
to fertility and the development of second<br />
malignancies). The German Hodgkin<br />
Disease Study Group has proposed a<br />
prognostic model for advanced stage disease,<br />
and has identified seven factors<br />
which influence outcome. These are age,<br />
sex, histology, B symptoms, number of<br />
Group. Blood, 84: 1361-1392.<br />
5. Macintyre EA, Delabesse E (1999) Molecular<br />
approaches to the diagnosis and evaluation of lymphoid<br />
malignancies. Semin Hematol, 36: 373-389.<br />
6. Bierman PJ, Armitage JO (1996) Non-Hodgkin's lymphoma.<br />
Curr Opin Hematol, 3: 266-272.<br />
7. Pinkerton CR (1999) The continuing challenge of treatment<br />
for non-Hodgkin's lymphoma in children. Br J<br />
Haematol, 107: 220-234.<br />
8. Zucca E, Bertoni F, Roggero E, Cavalli F (2000) The<br />
gastric marginal zone B-cell lymphoma of MALT type.<br />
Blood, 96: 410-419.<br />
9. International Non-Hodgkin's Lymphoma Prognostic<br />
Factors Project (1993) A predictive model for aggressive<br />
involved sites, bulk of disease and erythrocyte<br />
sedimentation rate. Using such<br />
models it may be possible to identify poor<br />
prognosis patients who will benefit from<br />
more aggressive high-dose therapies,<br />
such as Stanford V (doxorubicin, vinblastine,<br />
mustard, bleomycin, vincristine,<br />
etoposide and prednisone) or BEACOPP<br />
(bleomycin, etoposide, adriamycin [doxorubicin],<br />
cyclophosphamide, oncovin<br />
[vincristine], procarbazine and prednisone)<br />
from the outset (Medical oncology,<br />
p281).<br />
Survival for both Hodgkin disease and<br />
non-Hodgkin lymphomas has improved<br />
markedly with time, in response to the<br />
development of more effective<br />
chemotherapy and bone marrow transplantation.<br />
Five-year survival after diagnosis<br />
of non-Hodgkin lymphoma patients in<br />
most developed countries is more than<br />
50%, but only 17-35% in developing countries<br />
(Fig. 5.107). Currently, survival of<br />
Hodgkin disease patients is related to<br />
extent of disease at diagnosis; overall, at<br />
five years it is between 70% and 90% in<br />
North America and Europe, but only 30-<br />
55% in developing countries (Fig. 5.106).<br />
non-Hodgkin's lymphoma. The International Non-<br />
Hodgkin's Lymphoma Prognostic Factors Project. N Engl J<br />
Med, 329: 987-994.<br />
10. Horwitz SM, Horning SJ (2000) Advances in the treatment<br />
of Hodgkin's lymphoma. Curr Opin Hematol, 7: 235-240.<br />
11. Aisenberg AC (1999) Problems in Hodgkin's disease<br />
management. Blood, 93: 761-779.<br />
Lymphoma<br />
241