Therapeutic decision making in BMT/SCT for Hodgkin lymphoma

Disease classification page 127 Disease staging 128 Prognostic factors for outcome with conventional therapy 128 Risk factors for early-stage Hodgkin lymphoma 128 Risk factors for advanced Hodgkin lymphoma 129 Results with conventional therapy in adult patients 129 Results with autologous transplant 129 Results with myeloablative allogeneic transplant 133 Results with nonmyeloablative allogeneic transplant 134 Indications for autologous transplant 136 Recommendations for salvage chemotherapy 136 Contraindications to autologous transplant 136 Indications for allogeneic transplant 137 Monitoring posttransplant 137 Further reading 137 Disease classification Disease staging Modified Ann Arbor Staging System: Stage I: Involvement of a single lymph node region (I) or of a single extralymphatic organ or site (I_E). Stage II: Involvement of two or more lymph node regions on the same side of the diaphragm (II) or localized involvement of an extralymphatic organ or site and of one or more lymph node regions on the same side of the diaphragm (II_E). Stage III: Involvement of lymph node regions on both sides of the diaphragm (III), which may also be accompanied by localized involvement of an extralymphatic organ or site (III_E). Stage IV: Diffuse or disseminated involvement of one or more extralymphatic organs in tissues with or without associated lymph node enlargement. Systemic symptoms: Each stage is subdivided into A and B categories, B for patients with defined symptoms, and A for those without. The B classification is for patients with (1) unexplained weight loss of more than 10% of body weight in the 6 months before admission, (2) unexplained fever, with temperatures above 38°C, or (3) night sweats.